MEDICARE: DR. JEFFREY FRANK CAPPUCCIO D.C.

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	111NS0005X	Sports Physician Chiropractor	DC-003212-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275538183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY FRANK CAPPUCCIO D.C.

Provider Business Mailing Address
First Line	:	1635 BRODHEAD RD
Second Line	:
City	:	MOON TWP
State	:	PA
Zip	:	15108-3842
Country	:	US
Telephone Number	:	724-457-1900
Fax Number	:	724-457-1901

Provider Business Practice Location Address
First Line	:	1635 BRODHEAD RD
Second Line	:
City	:	MOON TWP
State	:	PA
Zip	:	15108-3842
Country	:	US
Telephone Number	:	724-457-1900
Fax Number	:	724-457-1901

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/01/2009

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