Provider Demographics
NPI:1407905144
Name:CAPASSO, NICOLE GABRIELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:GABRIELLE
Last Name:CAPASSO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 BISHOPS VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3453
Mailing Address - Country:US
Mailing Address - Phone:770-842-0871
Mailing Address - Fax:
Practice Address - Street 1:3 JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2719
Practice Address - Country:US
Practice Address - Phone:856-228-3100
Practice Address - Fax:856-228-3108
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00650800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor