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General NPI Number Information
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NPI Number | 1215133665
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Entity Type | Individual
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Provider Name | VINCENT CAPONE
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Gender | Male
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 620 HOWARD AVE
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City | ALTOONA
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State | PA
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Zip | 16601-4804
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Country | US
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Telephone | 814-381-1288
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Fax |
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Provider Business Mailing Address
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Address Line | 280 FAY ST
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City | HOLLIDAYSBURG
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State | PA
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Zip | 16648-9638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA055604
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License Number State | PA
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