Healthcare Provider Details

I. General information

NPI: 1851493464
Provider Name (Legal Business Name): ANDREA ESPINOSA RPA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 N BROADWAY SUITE 204
SLEEPY HOLLOW NY
10591-1000
US

IV. Provider business mailing address

777 N BROADWAY SUITE 204
SLEEPY HOLLOW NY
10591-1000
US

V. Phone/Fax

Practice location:
  • Phone: 914-631-3660
  • Fax: 914-631-0290
Mailing address:
  • Phone: 914-631-3660
  • Fax: 914-631-0290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number006758
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: