Basic Information
Provider Information
NPI: 1992254841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESPOSITO
FirstName: LINDSAY
MiddleName: RITZ
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RITZ
OtherFirstName: LINDSAY
OtherMiddleName: SARAH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 129 W 29TH ST FL 10
Address2:  
City: NEW YORK
State: NY
PostalCode: 100015105
CountryCode: US
TelephoneNumber: 4156586791
FaxNumber:  
Practice Location
Address1: 489 5TH AVE FL 3
Address2:  
City: NEW YORK
State: NY
PostalCode: 100176145
CountryCode: US
TelephoneNumber: 2124414400
FaxNumber: 2128674353
Other Information
ProviderEnumerationDate: 10/03/2016
LastUpdateDate: 07/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X020701-1NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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