Provider Demographics
NPI:1336141233
Name:CAPPA, JOHN (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CAPPA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1315
Mailing Address - Country:US
Mailing Address - Phone:914-946-9059
Mailing Address - Fax:914-948-4768
Practice Address - Street 1:309 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1315
Practice Address - Country:US
Practice Address - Phone:914-946-9059
Practice Address - Fax:914-948-4768
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004213213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP45071Medicare PIN
T51426Medicare UPIN
NY5149830001Medicare NSC