MEDICARE: DR. CHRISTINE ANNE CAPURSO L.A.C., DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	008494	NY
2	171100000X	Acupuncturist	006493	NY

General Provider Information

NPI Number	:	1023135332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE ANNE CAPURSO L.A.C., DC

Provider Business Mailing Address
First Line	:	475 E MAIN ST STE 115
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-3121
Country	:	US
Telephone Number	:	631-419-6300
Fax Number	:	888-880-9756

Provider Business Practice Location Address
First Line	:	475 E MAIN ST STE 115
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-3121
Country	:	US
Telephone Number	:	631-419-6300
Fax Number	:	888-880-9756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	03/04/2025

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