Healthcare Provider Details

I. General information

NPI: 1407046576
Provider Name (Legal Business Name): ROSE ELEANOR ESPOSITO PH. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 W 72ND ST 1C
NEW YORK NY
10023-2817
US

IV. Provider business mailing address

260 W 72ND ST 1C
NEW YORK NY
10023-2817
US

V. Phone/Fax

Practice location:
  • Phone: 212-769-0566
  • Fax:
Mailing address:
  • Phone: 212-769-0566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number006942
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: