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NPI Code Detail

MEDICARE: GINA CAPPO LMSW

MEDICARE: GINA CAPPO LMSW
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
11041C0700XClinical Social Worker067751-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1067751-1OTHERNYLMSW LICENSE

General Provider Information

NPI Number : 1598757460
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA CAPPO LMSW
Provider Business Mailing Address
First Line : 29 N HAMILTON ST
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-2541
Country : US
Telephone Number : 845-452-1110
Fax Number : 845-452-1119
Provider Business Practice Location Address
First Line : 223 MAIN ST
Second Line :
City : BEACON
State : NY
Zip : 12508-2770
Country : US
Telephone Number : 845-838-4900
Fax Number : 845-838-4915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 07/08/2007

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Directions to “ GINA CAPPO LMSW” Practice Location

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