Provider Demographics
NPI:1194402735
Name:ESPOSITO, SOFIA O
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:O
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-0098
Mailing Address - Country:US
Mailing Address - Phone:908-674-3183
Mailing Address - Fax:
Practice Address - Street 1:100 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:BUDD LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07828-1383
Practice Address - Country:US
Practice Address - Phone:833-282-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-04
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician