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NPI Code Detail

MEDICARE: BLESILA G CAPILLA PT

MEDICARE: BLESILA G CAPILLA PT
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
1225100000XPhysical TherapistNJ

General Provider Information

NPI Number : 1386674588
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLESILA G CAPILLA PT
Provider Business Mailing Address
First Line : 2222 SULLIVAN TRL
Second Line :
City : EASTON
State : PA
Zip : 18040-7958
Country : US
Telephone Number : 610-991-2034
Fax Number :
Provider Business Practice Location Address
First Line : 70 STOCKTON AVE
Second Line :
City : OCEAN GROVE
State : NJ
Zip : 07756-1150
Country : US
Telephone Number : 732-774-1316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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Directions to “ BLESILA G CAPILLA PT” Practice Location

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