Healthcare Provider Details
I. General information
NPI: 1063336733
Provider Name (Legal Business Name): OUTRO MEDICAL EAST, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
53 FRONTAGE RD FL 1
HAMPTON NJ
08827-4031
US
IV. Provider business mailing address
49 ELIZABETH ST FL 5
NEW YORK NY
10013-4636
US
V. Phone/Fax
- Phone: 949-649-4093
- Fax: 949-818-5372
- Phone: 949-649-4093
- Fax: 949-818-5372
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BRADLEY
ESTERMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 949-649-4093