Basic Information
| Provider Information | |||||||||
| NPI: | 1598000168 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESPOSITO | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | COTA.L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 575 CLAYTON ST | ||||||||
| Address2: | |||||||||
| City: | CENTRAL ISLIP | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117223021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312340550 | ||||||||
| FaxNumber: | 6312340635 | ||||||||
| Practice Location | |||||||||
| Address1: | 575 CLAYTON ST | ||||||||
| Address2: | |||||||||
| City: | CENTRAL ISLIP | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117223021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312340550 | ||||||||
| FaxNumber: | 6312340635 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2012 | ||||||||
| LastUpdateDate: | 12/07/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 006813-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.