1790275535 NPI number — SILVANNA ESPOSITO MD

Table of content: SILVANNA ESPOSITO MD (NPI 1790275535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790275535 NPI number — SILVANNA ESPOSITO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ESPOSITO
Provider First Name:
SILVANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790275535
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1727
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81502-1727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-263-2600
Provider Business Mailing Address Fax Number:
970-263-2692

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
731 IOWA AVE
Provider Second Line Business Practice Location Address:
UNIT A
Provider Business Practice Location Address City Name:
PALISADE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81526-8661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-644-4050
Provider Business Practice Location Address Fax Number:
970-644-3940
Provider Enumeration Date:
05/17/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  311593 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: DR.0068952 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9000208126 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com