Healthcare Provider Details

I. General information

NPI: 1780730077
Provider Name (Legal Business Name): ALEXANDER ANTHONY ESPOSITO JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 VICTORY BLVD
STATEN ISLAND NY
10301-3623
US

IV. Provider business mailing address

86 OCEAN TER
STATEN ISLAND NY
10314-5650
US

V. Phone/Fax

Practice location:
  • Phone: 718-448-9272
  • Fax: 718-448-9144
Mailing address:
  • Phone: 718-448-9272
  • Fax: 718-448-9144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberX010351
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: