MEDICARE: EMILY CAPOLUPO MS, RD, LDN

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	133V00000X	Registered Dietitian	DT91315	TX

General Provider Information

NPI Number	:	1750105102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY CAPOLUPO MS, RD, LDN

Provider Business Mailing Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY APT N108
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3713
Country	:	US
Telephone Number	:	609-529-1034
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY APT N108
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3713
Country	:	US
Telephone Number	:	609-529-1034
Fax Number	:

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

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	11/12/2024

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