Healthcare Provider Details

I. General information

NPI: 1144062779
Provider Name (Legal Business Name): SHERRY BETH CAPUTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5034 ATLANTIC AVE
MAYS LANDING NJ
08330-2022
US

IV. Provider business mailing address

2139 E CHESTNUT AVE APT 7
VINELAND NJ
08361-8457
US

V. Phone/Fax

Practice location:
  • Phone: 609-782-0005
  • Fax:
Mailing address:
  • Phone: 609-705-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number26NR16157400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: