Provider Demographics
NPI:1083912356
Name:CAPPELLANO, JOSEPH GERARD (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GERARD
Last Name:CAPPELLANO
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2818
Mailing Address - Country:US
Mailing Address - Phone:718-945-6900
Mailing Address - Fax:718-945-0557
Practice Address - Street 1:10000 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2818
Practice Address - Country:US
Practice Address - Phone:718-945-6900
Practice Address - Fax:718-945-0557
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005498-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist