MEDICARE: PRODIGY MEDICAL MANAGEMENT

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	208600000X	Surgery Physician

General Provider Information

NPI Number	:	1538885272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRODIGY MEDICAL MANAGEMENT

Provider Business Mailing Address
First Line	:	71 UNION AVE STE 210
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-1272
Country	:	US
Telephone Number	:	551-285-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	71 UNION AVE STE 210
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-1272
Country	:	US
Telephone Number	:	551-285-4250
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANGELO CAPRIO
Credential	:	MD
Telephone Number	:	201-892-9397

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	02/24/2026

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Directions to “PRODIGY MEDICAL MANAGEMENT ” Practice Location

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