Provider Demographics
NPI:1215961305
Name:ESPOSITO, VINCENT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:MICHAEL
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:414 W 54TH ST
Mailing Address - Street 2:APT. 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4442
Mailing Address - Country:US
Mailing Address - Phone:212-586-3495
Mailing Address - Fax:212-595-0342
Practice Address - Street 1:10 W 86TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3606
Practice Address - Country:US
Practice Address - Phone:212-595-1234
Practice Address - Fax:212-595-0342
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY127860207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY16E043Medicare ID - Type Unspecified
NYB12900Medicare UPIN