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General NPI Number Information
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NPI Number | 1225355548
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Entity Type | Organization
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Legal Business Name | EDDY CAPOTE JR. MD PC
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Dates
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Enumeration Date | 04/26/2010
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 13105 CENTERLINE RD
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City | SOUTH WALES
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State | NY
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Zip | 14139-9764
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Country | US
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Telephone | 716-713-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 13105 CENTERLINE RD
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City | SOUTH WALES
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State | NY
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Zip | 14139-9764
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Country | US
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Telephone | 716-713-1433
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. EDDY CAPOTE JR.
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Credential | MD
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Telephone | 716-713-1433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 251634
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License Number State | NY
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