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NPI Code Detail

MEDICARE: MS. ELIZABETH M CAPPELLETTI-WALKER PA

MEDICARE: MS. ELIZABETH M CAPPELLETTI-WALKER PA
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
1363A00000XPhysician Assistant008454NY

General Provider Information

NPI Number : 1225261894
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH M CAPPELLETTI-WALKER PA
Provider Business Mailing Address
First Line : 329 N SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1755
Country : US
Telephone Number : 315-373-0361
Fax Number :
Provider Business Practice Location Address
First Line : 329 N SALINA ST
Second Line :
City : SYRACUSE
State : NY
Zip : 13203-1755
Country : US
Telephone Number : 313-373-0361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2009
Last Update Date : 10/15/2024

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