Provider Demographics
NPI:1215141056
Name:MICHAEL ESPOSITO & RICHARD GINSBURG PTR
Entity type:Organization
Organization Name:MICHAEL ESPOSITO & RICHARD GINSBURG PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:GINSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-436-4991
Mailing Address - Street 1:614 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-436-4991
Mailing Address - Fax:518-432-6427
Practice Address - Street 1:614 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208
Practice Address - Country:US
Practice Address - Phone:518-436-4991
Practice Address - Fax:518-432-6427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03218715Medicaid
NY03218715Medicaid
E5312985Medicare ID - Type Unspecified
NY00568630Medicaid
B78675Medicare UPIN
NY01269474Medicaid