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General NPI Number Information
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NPI Number | 1568891547
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Entity Type | Individual
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Provider Name | KRISTEN NICOLE ESPOSITO P.A.
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Gender | Female
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Dates
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Enumeration Date | 11/11/2013
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 14 TECHNOLOGY DR SUITE 11
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City | EAST SETAUKET
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State | NY
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Zip | 11733-3472
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Country | US
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Telephone | 631-444-4233
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Fax | 631-444-7671
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Provider Business Mailing Address
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Address Line | STONY BROOK UNIVERSITY HOSPITAL DEPARTMENT OF ORTHOPAEDICS H.S.C T-18, RM 020
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City | STONY BROOK
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State | NY
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Zip | 11794
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Country | US
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Telephone | 631-444-7670
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Fax | 631-444-7671
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 017097
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License Number State | NY
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