Healthcare Provider Details

I. General information

NPI: 1275447278
Provider Name (Legal Business Name): MARCUS CAPOBIANCO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 NOTT ST
SCHENECTADY NY
12308-1812
US

IV. Provider business mailing address

461 NOTT ST
SCHENECTADY NY
12308-1812
US

V. Phone/Fax

Practice location:
  • Phone: 518-379-1312
  • Fax:
Mailing address:
  • Phone: 518-379-1312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number074570
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: