Provider Demographics
NPI:1134121734
Name:CAPPIELLO, ZINA B (DPM)
Entity Type:Individual
Prefix:DR
First Name:ZINA
Middle Name:B
Last Name:CAPPIELLO
Suffix:
Gender:F
Credentials:DPM
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:886 POMPTON AVENUE
Mailing Address - Street 2:SUIT A-1; CANFIELD OFFICE PARK
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1257
Mailing Address - Country:US
Mailing Address - Phone:973-857-1184
Mailing Address - Fax:973-857-3114
Practice Address - Street 1:886 POMPTON AVENUE
Practice Address - Street 2:SUIT A-1; CANFIELD OFFICE PARK
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1257
Practice Address - Country:US
Practice Address - Phone:973-857-1184
Practice Address - Fax:973-857-3114
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005576213E00000X
NJ25MA00261100213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8552002Medicaid
NJ8552002Medicaid
NJ049663PZRMedicare PIN
NJ480033530Medicare PIN