Healthcare Provider Details

I. General information

NPI: 1922316165
Provider Name (Legal Business Name): LUCIA MICHELLE CAPITELLI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 SHERMAN AVE
NEW YORK NY
10040-1602
US

IV. Provider business mailing address

26 SHERMAN AVE
NEW YORK NY
10040-1602
US

V. Phone/Fax

Practice location:
  • Phone: 212-942-8774
  • Fax: 212-567-2019
Mailing address:
  • Phone: 212-942-8774
  • Fax: 212-567-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number328187
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: