Provider Demographics
NPI:1275075699
Name:CAPRITTO, KENNETH (CO, BOCP)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:
Last Name:CAPRITTO
Suffix:
Gender:M
Credentials:CO, BOCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69156 HIGHWAY 190 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5140
Mailing Address - Country:US
Mailing Address - Phone:985-966-3484
Mailing Address - Fax:
Practice Address - Street 1:69156 HIGHWAY 190 SERVICE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5140
Practice Address - Country:US
Practice Address - Phone:985-966-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Yes335E00000XSuppliersProsthetic/Orthotic Supplier