Provider Demographics
NPI:1184819989
Name:NOEL S CAPPILLO DC PC
Entity Type:Organization
Organization Name:NOEL S CAPPILLO DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAPPILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:781-237-5118
Mailing Address - Street 1:148 LINDEN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7900
Mailing Address - Country:US
Mailing Address - Phone:781-237-5118
Mailing Address - Fax:
Practice Address - Street 1:148 LINDEN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7900
Practice Address - Country:US
Practice Address - Phone:781-237-5118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANOY49105OtherMEDICARE GROUP #
MANOY49105OtherMEDICARE GROUP #