Provider Demographics
NPI:1316166358
Name:ESPOSITO, VINCENT (DC)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
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 1:3021 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4232
Mailing Address - Country:US
Mailing Address - Phone:718-627-1127
Mailing Address - Fax:
Practice Address - Street 1:3021 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4232
Practice Address - Country:US
Practice Address - Phone:718-627-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3468111N00000X
NY003-776133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC03468-8BOtherWORKERS COMPENSATION
NYC03468-8BOtherWORKERS COMPENSATION