Healthcare Provider Details

I. General information

NPI: 1447196175
Provider Name (Legal Business Name): MARLO CAPOCCIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2228 MOONSHINE RD
AURORA NY
13026-9768
US

IV. Provider business mailing address

2228 MOONSHINE RD
AURORA NY
13026-9768
US

V. Phone/Fax

Practice location:
  • Phone: 607-342-6228
  • Fax:
Mailing address:
  • Phone: 607-342-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number707664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: