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General NPI Number Information
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NPI Number | 1598954158
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Entity Type | Organization
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Legal Business Name | ANTHONY CAPPELLINO MD PC
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Dates
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Enumeration Date | 10/19/2007
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 60 FLEETS POINT DR SUITE 1
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City | WEST BABYLON
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State | NY
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Zip | 11704-8314
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Country | US
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Telephone | 631-321-0033
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Fax | 631-321-0039
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Provider Business Mailing Address
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Address Line | 60 FLEETS POINT DR SUITE 1
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City | WEST BABYLON
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State | NY
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Zip | 11704-8314
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Country | US
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Telephone | 631-321-0033
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Fax | 631-321-0039
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BARBARA HARRIS
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Credential | OFF. MGR
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Telephone | 631-321-0033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 211624NY
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License Number State | NY
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