MEDICARE: GREGG LOUIS CAPORASO MD

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	2084N0400X	Neurology Physician	202300	NY

General Provider Information

NPI Number	:	1790872893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGG LOUIS CAPORASO MD

Provider Business Mailing Address
First Line	:	322 UNDERHILL AVE
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4557
Country	:	US
Telephone Number	:	914-302-2140
Fax Number	:	914-302-2276

Provider Business Practice Location Address
First Line	:	322 UNDERHILL AVE
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4557
Country	:	US
Telephone Number	:	914-302-2140
Fax Number	:	914-302-2276

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

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	09/13/2012

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