Healthcare Provider Details

I. General information

NPI: 1124993027
Provider Name (Legal Business Name): LAURA ESPOSITO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 CLEAR MEADOW DR
FREEDOM NY
14065-9729
US

IV. Provider business mailing address

1715 CLEAR MEADOW DR
FREEDOM NY
14065-9729
US

V. Phone/Fax

Practice location:
  • Phone: 716-955-9138
  • Fax:
Mailing address:
  • Phone: 716-955-9138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: