Healthcare Provider Details

I. General information

NPI: 1639753619
Provider Name (Legal Business Name): DELIA ESPOSITO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 S MAIN ST
NEW CITY NY
10956-3511
US

IV. Provider business mailing address

77 S MAIN ST
NEW CITY NY
10956-3511
US

V. Phone/Fax

Practice location:
  • Phone: 845-474-3427
  • Fax: 845-634-7839
Mailing address:
  • Phone: 845-474-3427
  • Fax: 845-634-7839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112465-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: