Healthcare Provider Details

I. General information

NPI: 1033132253
Provider Name (Legal Business Name): JESUS ISABEL ESPINOZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CHURCH AVE FLATBUSH CENTER
BROOKLYN NY
11218
US

IV. Provider business mailing address

233 NOSTRAND AVE
BROOKLYN NY
11205
US

V. Phone/Fax

Practice location:
  • Phone: 718-826-4000
  • Fax: 718-826-4075
Mailing address:
  • Phone: 718-826-5911
  • Fax: 718-826-5800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1335221
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7038INACTIVE
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: