MEDICARE: MS. NEYSA I VALENTIN-CAPELES DO

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	202814-1	NY
2	2086S0129X	Vascular Surgery Physician	202814	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790781375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NEYSA I VALENTIN-CAPELES DO

Provider Business Mailing Address
First Line	:	327 BEACH 19TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4423
Country	:	US
Telephone Number	:	516-400-9302
Fax Number	:	516-400-9309

Provider Business Practice Location Address
First Line	:	275 ROCKAWAY TPKE
Second Line	:
City	:	LAWRENCE
State	:	NY
Zip	:	11559
Country	:	US
Telephone Number	:	516-400-9302
Fax Number	:	516-400-9309

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	11/06/2018

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