Provider Demographics
NPI:1447437264
Name:ANTHONY J ESPOSITO, DPM
Entity type:Organization
Organization Name:ANTHONY J ESPOSITO, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-646-3708
Mailing Address - Street 1:2315 ROYCE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6615
Mailing Address - Country:US
Mailing Address - Phone:917-807-9445
Mailing Address - Fax:718-646-1434
Practice Address - Street 1:2305 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4916
Practice Address - Country:US
Practice Address - Phone:718-646-3708
Practice Address - Fax:718-646-1434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004882-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4425980001Medicare NSC