MEDICARE: JENNIFER CAPUANO 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
1	363A00000X	Physician Assistant	022163	NY

General Provider Information

NPI Number	:	1487132486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER CAPUANO PA

Provider Business Mailing Address
First Line	:	30 N UNION RD STE 102
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-5367
Country	:	US
Telephone Number	:	716-839-8000
Fax Number	:	716-839-8009

Provider Business Practice Location Address
First Line	:	30 N UNION RD STE 102
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-5367
Country	:	US
Telephone Number	:	716-839-8000
Fax Number	:	716-839-8009

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

Provider Enumeration Date	:	08/01/2018
Last Update Date	:	12/26/2025

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Directions to “ JENNIFER CAPUANO PA” Practice Location

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