MEDICARE: STEPHANIE ESPOSITO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	003076	CT

General Provider Information

NPI Number	:	1750334801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE ESPOSITO APRN

Provider Business Mailing Address
First Line	:	9 WASHINGTON AVE
Second Line	:	SUITE 3RD FLOOR
City	:	HAMDEN
State	:	CT
Zip	:	06518-3267
Country	:	US
Telephone Number	:	203-288-6860
Fax Number	:	203-288-3283

Provider Business Practice Location Address
First Line	:	1 BRADLEY RD
Second Line	:	SUITE 709
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-2285
Country	:	US
Telephone Number	:	203-397-3950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/13/2013

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