Healthcare Provider Details

I. General information

NPI: 1285559112
Provider Name (Legal Business Name): GABRIELLE ESPOSITO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CHESTNUT ST
RIDGEWOOD NJ
07450-2504
US

IV. Provider business mailing address

79 MARINUS ST
ROCHELLE PARK NJ
07662-3825
US

V. Phone/Fax

Practice location:
  • Phone: 201-444-3550
  • Fax:
Mailing address:
  • Phone: 201-655-4086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number37AC00971000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: