Provider Demographics
NPI:1083729743
Name:CAPPALLI, ELIZABETH A (RD, LDN, CDE,CDOE)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:CAPPALLI
Suffix:
Gender:F
Credentials:RD, LDN, CDE,CDOE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 FERNCREST AVE
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-5818
Mailing Address - Country:US
Mailing Address - Phone:401-822-4886
Mailing Address - Fax:
Practice Address - Street 1:141 POWER RD
Practice Address - Street 2:SUITE 107
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-3429
Practice Address - Country:US
Practice Address - Phone:401-725-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00269133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI036170OtherVAMC NFS
RI404424Medicare UPIN
RIP00144404Medicare UPIN
RI63-00096Medicare UPIN
RI20697-8Medicare UPIN
RI036170OtherVAMC NFS
RI20703-2Medicare UPIN
RI63-00090Medicare UPIN