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General NPI Number Information
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NPI Number | 1760889331
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Entity Type | Organization
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Legal Business Name | JOHN CAPINO MD PC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 1230 BRIDGE ST SUITE 2
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City | LOWELL
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State | MA
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Zip | 01850-1291
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Country | US
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Telephone | 978-452-2100
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Fax | 978-446-0490
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Provider Business Mailing Address
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Address Line | 1230 BRIDGE ST SUITE 2
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City | LOWELL
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State | MA
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Zip | 01850-1291
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Country | US
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Telephone | 978-452-2100
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Fax | 978-446-0490
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MADELEIN CAPINO
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Credential |
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Telephone | 978-452-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 57517
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License Number State | MA
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