Provider Demographics
NPI:1316139165
Name:STEPHEN P. ESPOSITO, M.D., P.C.
Entity type:Organization
Organization Name:STEPHEN P. ESPOSITO, M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-224-7186
Mailing Address - Street 1:2619 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358
Mailing Address - Country:US
Mailing Address - Phone:718-224-7186
Mailing Address - Fax:718-224-1680
Practice Address - Street 1:2619 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358
Practice Address - Country:US
Practice Address - Phone:718-224-7186
Practice Address - Fax:718-224-1680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05639OtherGROUP NUMBER
05639Medicare PIN
05639HMedicare PIN
05639GMedicare PIN
NYX86594Medicare UPIN