Individual
BORIS ESPINOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27 WICKS RD, BRENTWOOD, NY 11717-4213
(631) 231-5070
Mailing address
82 LAUREN AVE, DIX HILLS, NY 11746-6630
(631) 254-4735
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
169762-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01062555
—
NY
Enumeration date
11/09/2006
Last updated
07/08/2007
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