Provider Demographics
NPI:1003817735
Name:CAPUTO, NICHOLAS FRANCIS (CPHT)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:FRANCIS
Last Name:CAPUTO
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 STOCKTON ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-1346
Mailing Address - Country:US
Mailing Address - Phone:757-850-4985
Mailing Address - Fax:
Practice Address - Street 1:4601 IRONBOUND ROAD
Practice Address - Street 2:EASTERN STATE HOSPITAL
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23187
Practice Address - Country:US
Practice Address - Phone:757-253-5327
Practice Address - Fax:757-253-4521
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230000681183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0230000681OtherPHARMACY TECHNICIAN