Healthcare Provider Details

I. General information

NPI: 1730542200
Provider Name (Legal Business Name): ADIAC ESPINOSA HERNANDEZ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 10TH AVE
NEW YORK NY
10019-1147
US

IV. Provider business mailing address

ONE GUSTAVE L. LEVY PLACE, BOX 1232
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-8663
  • Fax:
Mailing address:
  • Phone: 212-241-6694
  • Fax: 212-876-5519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME159710
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: