Healthcare Provider Details

I. General information

NPI: 1316044571
Provider Name (Legal Business Name): JAMES R. CAPUTO M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

739 IRVING AVE SUITE 300
SYRACUSE NY
13210-1640
US

IV. Provider business mailing address

739 IRVING AVE SUITE 300
SYRACUSE NY
13210-1640
US

V. Phone/Fax

Practice location:
  • Phone: 315-475-8599
  • Fax: 315-475-8577
Mailing address:
  • Phone: 315-475-8599
  • Fax: 315-475-8577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number206065-1
License Number StateNY

VIII. Authorized Official

Name: JAMES RICHARD CAPUTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 315-475-8599