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Individual
SAMUEL LOUIS ESPOSITO III
Active
Individual
SAMUEL LOUIS ESPOSITO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA059318
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033717200001
—
PA
01
—
615487F6K
MEDICARE
PA
Enumeration date
09/27/2017
Last updated
10/18/2022
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