Provider Demographics
NPI:1205030814
Name:CAPALBO, JILL M (DC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:CAPALBO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAPALBO PL
Mailing Address - Street 2:
Mailing Address - City:COS COB
Mailing Address - State:CT
Mailing Address - Zip Code:06807-2111
Mailing Address - Country:US
Mailing Address - Phone:203-661-0646
Mailing Address - Fax:
Practice Address - Street 1:25 3RD ST
Practice Address - Street 2:SUITE 440
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5100
Practice Address - Country:US
Practice Address - Phone:203-323-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001249111NS0005X
NY008848111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician