MEDICARE: CHARLES R ESPOSITO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	022809	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1204198	OTHER	UNITED HEALTH CARE
2	030702	OTHER	HEALTH NET
3	010022809CT01	OTHER	BLUE CROSS
4	NLP028	OTHER	OXFORD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	01022809	OTHER	CIGNA

General Provider Information

NPI Number	:	1548359078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES R ESPOSITO M.D.

Provider Business Mailing Address
First Line	:	1527 ROUTE 12
Second Line	:	PO BOX 608
City	:	GALES FERRY
State	:	CT
Zip	:	06335-1800
Country	:	US
Telephone Number	:	860-464-7248
Fax Number	:	860-464-0125

Provider Business Practice Location Address
First Line	:	1527 ROUTE 12
Second Line	:
City	:	GALES FERRY
State	:	CT
Zip	:	06335-1800
Country	:	US
Telephone Number	:	860-464-7248
Fax Number	:	860-464-0125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	01/23/2013

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Directions to “ CHARLES R ESPOSITO M.D.” Practice Location

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