Healthcare Provider Details

I. General information

NPI: 1356484174
Provider Name (Legal Business Name): WILLIAM NICHOLAS CAPICOTTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6580 MAIN ST STE 2
WILLIAMSVILLE NY
14221
US

IV. Provider business mailing address

6580 MAIN ST STE 2
WILLIAMSVILLE NY
14221-5819
US

V. Phone/Fax

Practice location:
  • Phone: 716-881-0382
  • Fax: 716-881-0422
Mailing address:
  • Phone: 716-881-0382
  • Fax: 716-881-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number146-658
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number146658
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: