Healthcare Provider Details

I. General information

NPI: 1336861905
Provider Name (Legal Business Name): DALILA YAMILE ESPINAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 09/12/2022
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9272 KENNEDY BLVD
NORTH BERGEN NJ
07047-5308
US

IV. Provider business mailing address

217 46TH ST APT 1
UNION CITY NJ
07087-6367
US

V. Phone/Fax

Practice location:
  • Phone: 551-306-1820
  • Fax:
Mailing address:
  • Phone: 201-874-1624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZA2600X
TaxonomyMedical Art Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: