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General NPI Number Information
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NPI Number | 1871611012
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Entity Type | Organization
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Legal Business Name | CHRISTIAN N. CAPUTO, LCSW, P.C.
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 619 ROANOKE AVE
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City | RIVERHEAD
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State | NY
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Zip | 11901-2727
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Country | US
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Telephone | 631-369-1718
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Fax |
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Provider Business Mailing Address
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Address Line | 166 HAMPTON VISTA DR
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City | MANORVILLE
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State | NY
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Zip | 11949-2861
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Country | US
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Telephone | 631-369-1718
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Fax | 631-874-8618
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTIAN NICHOLAS CAPUTO
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Credential | LCSW
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Telephone | 631-369-1718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | RP 003027-1
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License Number State | NY
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