Provider Demographics
NPI:1952907651
Name:ESPOSITO, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 STAFFORDSHIRE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1757
Mailing Address - Country:US
Mailing Address - Phone:203-506-9632
Mailing Address - Fax:
Practice Address - Street 1:82 STAFFORDSHIRE COMMONS DR
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1757
Practice Address - Country:US
Practice Address - Phone:203-506-9632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT155827163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency