Provider Demographics
NPI:1790651560
Name:ESPOSITO, LAURA (MSED)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SHAFER CT
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-6122
Mailing Address - Country:US
Mailing Address - Phone:917-680-0287
Mailing Address - Fax:
Practice Address - Street 1:25 SHAFER CT
Practice Address - Street 2:
Practice Address - City:PINE BUSH
Practice Address - State:NY
Practice Address - Zip Code:12566-6122
Practice Address - Country:US
Practice Address - Phone:917-680-0287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist