Healthcare Provider Details

I. General information

NPI: 1174410450
Provider Name (Legal Business Name): JHOSELIN VANESA ESPINOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9109 ROOSEVELT AVE
JACKSON HEIGHTS NY
11372-7995
US

IV. Provider business mailing address

3077 14TH ST
ASTORIA NY
11102-3895
US

V. Phone/Fax

Practice location:
  • Phone: 718-908-8000
  • Fax:
Mailing address:
  • Phone: 646-836-1360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: