MEDICARE: LINDSAY-ANNE RILEY CAPUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW134927	PA

General Provider Information

NPI Number	:	1033624507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY-ANNE RILEY CAPUS

Provider Business Mailing Address
First Line	:	1266 ASHBOURNE RD
Second Line	:
City	:	ELKINS PARK
State	:	PA
Zip	:	19027-2703
Country	:	US
Telephone Number	:	215-680-3490
Fax Number	:

Provider Business Practice Location Address
First Line	:	2605 EGYPT RD STE 204
Second Line	:
City	:	TROOPER
State	:	PA
Zip	:	19403-2317
Country	:	US
Telephone Number	:	484-849-1482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2017
Last Update Date	:	12/06/2017

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Directions to “ LINDSAY-ANNE RILEY CAPUS ” Practice Location

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