Provider Demographics
NPI:1306874177
Name:ESPOSITO, ANTONIO SALVATORE (DC)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:SALVATORE
Last Name:ESPOSITO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 WASHINGTON AVENUE
Mailing Address - Street 2:STE ONE
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2340
Mailing Address - Country:US
Mailing Address - Phone:201-384-3300
Mailing Address - Fax:201-384-2745
Practice Address - Street 1:175 WASHINGTON AVENUE
Practice Address - Street 2:STE ONE
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2340
Practice Address - Country:US
Practice Address - Phone:201-384-3300
Practice Address - Fax:201-384-2745
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00416900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
42729Medicare UPIN
NJES424672Medicare PIN