Provider Demographics
NPI:1407070030
Name:CAPPELMANN, SUSAN OLGA (RPA-C)
Entity Type:Individual
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First Name:SUSAN
Middle Name:OLGA
Last Name:CAPPELMANN
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:4230 DOUGLASTON PKWY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9525 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4511
Practice Address - Country:US
Practice Address - Phone:718-286-1011
Practice Address - Fax:718-286-1142
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY006065-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant