Basic Information
Provider Information
NPI: 1750642179
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESPOSITO
FirstName: JOSEPH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1500 LANSDOWNE AVE
Address2:  
City: DARBY
State: PA
PostalCode: 190231200
CountryCode: US
TelephoneNumber: 6102374210
FaxNumber:  
Practice Location
Address1: 10 NATHAN D PERLMAN PL
Address2:  
City: NEW YORK
State: NY
PostalCode: 100033851
CountryCode: US
TelephoneNumber: 2124202000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/01/2012
LastUpdateDate: 11/24/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/24/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0802X25MA10583500NJN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
2084P0802X300211-01NYN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
2084P0802XMD465936PAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry

No ID Information.


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