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General NPI Number Information
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NPI Number | 1730346115
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Entity Type | Organization
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Legal Business Name | CAP MEDICAL, LLC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 610 FRENCH RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-1014
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Country | US
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Telephone | 315-225-3534
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4272
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City | ROME
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State | NY
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Zip | 13442-4272
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Country | US
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Telephone | 315-225-3534
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Fax |
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Authorized Official
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Title or Position | SENIOR MEMBER
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Name | DR. JEFFREY D AMIDON
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Credential | D.O.
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Telephone | 315-225-3534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 192498-1
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License Number State | NY
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