Provider Demographics
NPI:1104827021
Name:ELLIOTT CAPOGNA, BARBARA A (CRNA)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:ELLIOTT CAPOGNA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1201 NOTT ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-374-3123
Mailing Address - Fax:518-374-9711
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:SUITE 106
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-374-3123
Practice Address - Fax:518-374-9711
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286842-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
9686562OtherGHI
33588UOtherFIDELIS MEDICARE
4123056OtherMVP
286842-1OtherTRICARE NORTH REGION
R6B58OtherBLUE CROSS
000000099315OtherGHI HMO
000495037001OtherBLUE SHIELD NENY
10002421OtherCDPHP
X00000OtherAMERICAN PROGRESSIVE TODA
286842-1OtherTRICARE NORTH REGION
4123056OtherMVP