Healthcare Provider Details

I. General information

NPI: 1174517015
Provider Name (Legal Business Name): JANET M CAPUTO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 PENN AVE
SCRANTON PA
18503-1920
US

IV. Provider business mailing address

240 PENN AVE
SCRANTON PA
18503-1920
US

V. Phone/Fax

Practice location:
  • Phone: 570-558-0290
  • Fax: 570-558-0291
Mailing address:
  • Phone: 570-558-0290
  • Fax: 570-558-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006765L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier562364
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUS HEALTHCARE
# 2
Identifier079324
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerFIRST PRIORITY HEALTH
# 3
Identifier5886154
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA
# 4
Identifier650019414
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerRAILROAD MEDICARE
# 5
Identifier001815119
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 6
Identifier66866-159B
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerGEISINGER HEALTH PLAN
# 7
IdentifierCA426823
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerBLUE SHIELD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: