Healthcare Provider Details

I. General information

NPI: 1467662924
Provider Name (Legal Business Name): LOUIS ANGELO ESPOSITO MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 11TH ST
BROOKLYN NY
11215-4010
US

IV. Provider business mailing address

365 11TH ST
BROOKLYN NY
11215-4010
US

V. Phone/Fax

Practice location:
  • Phone: 718-768-1282
  • Fax:
Mailing address:
  • Phone: 718-768-1282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number000765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: