Provider Demographics
NPI:1225394067
Name:ANTHONY R. CAPUTO, MD PA
Entity Type:Organization
Organization Name:ANTHONY R. CAPUTO, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CAPUTO,MD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-228-3111
Mailing Address - Street 1:556 EAGLE ROCK AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-1503
Mailing Address - Country:US
Mailing Address - Phone:973-228-3111
Mailing Address - Fax:973-226-4010
Practice Address - Street 1:556 EAGLE ROCK AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1503
Practice Address - Country:US
Practice Address - Phone:973-228-3111
Practice Address - Fax:973-226-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA25094207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1851501Medicaid
NJ1851501Medicaid
NJ191209Medicare PIN