Healthcare Provider Details

I. General information

NPI: 1013105634
Provider Name (Legal Business Name): DEBORAH LYNN CAPUTO APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 02/28/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 DAVIS AVE FL 4
NEPTUNE NJ
07753-4488
US

IV. Provider business mailing address

19 DAVIS AVE FL 4
NEPTUNE NJ
07753-4488
US

V. Phone/Fax

Practice location:
  • Phone: 732-974-0003
  • Fax: 732-974-0366
Mailing address:
  • Phone: 732-974-0003
  • Fax: 732-974-0366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NN07967600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: