Healthcare Provider Details

I. General information

NPI: 1538574835
Provider Name (Legal Business Name): DENISE ESPINAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129-135 RIDGE STREET, APT. 3E
NEW YORK NY
10002
US

IV. Provider business mailing address

129-135 RIDGE STREET, APT. 3E
NEW YORK NY
10002
US

V. Phone/Fax

Practice location:
  • Phone: 646-732-2027
  • Fax:
Mailing address:
  • Phone: 646-732-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: