Provider Demographics
NPI:1356484174
Name:CAPICOTTO, WILLIAM NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:NICHOLAS
Last Name:CAPICOTTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6580 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5819
Mailing Address - Country:US
Mailing Address - Phone:716-881-0382
Mailing Address - Fax:716-881-0422
Practice Address - Street 1:6580 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-881-0382
Practice Address - Fax:716-881-0422
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146658208600000X
NY146-658207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1356484174OtherNPPES