Provider Demographics
NPI:1437578911
Name:KAPO, MAIDA
Entity Type:Individual
Prefix:
First Name:MAIDA
Middle Name:
Last Name:KAPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAIDA
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8688 TIBBITTS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-5224
Mailing Address - Country:US
Mailing Address - Phone:315-542-4024
Mailing Address - Fax:
Practice Address - Street 1:8688 TIBBITTS RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-5224
Practice Address - Country:US
Practice Address - Phone:315-542-4024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24395225100000X
SC7088225100000X
NY030573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist