Provider Demographics
NPI:1528126315
Name:ESPEJO, MARIA TERESA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:TERESA
Last Name:ESPEJO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:234 EAST AND 149 ST
Mailing Address - Street 2:LINCOLN HOSPITAL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10541-1503
Mailing Address - Country:US
Mailing Address - Phone:718-579-5580
Mailing Address - Fax:718-579-6532
Practice Address - Street 1:234 E 149TH STREET
Practice Address - Street 2:LINCOLN HOSPITAL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5580
Practice Address - Fax:718-579-4836
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-11-03
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Provider Licenses
StateLicense IDTaxonomies
NY226096207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01977715Medicaid
NY01977715Medicaid