Healthcare Provider Details

I. General information

NPI: 1831216209
Provider Name (Legal Business Name): SYLVIA M. KAPUTSOS OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CIVIC AVE
SALISBURY MD
21804-4599
US

IV. Provider business mailing address

4325 RAMBLIN RD.
SALISBURY MD
21804-2735
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-1466
  • Fax:
Mailing address:
  • Phone: 410-860-6863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number01482
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberU1-0000055
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: