Provider Demographics
NPI:1497968721
Name:NAHMIAS-CAPON, NISSIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NISSIN
Middle Name:
Last Name:NAHMIAS-CAPON
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 1:2 PARK PL APT 18B
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5016
Mailing Address - Country:US
Mailing Address - Phone:267-970-1131
Mailing Address - Fax:
Practice Address - Street 1:95 WOODLAND ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1230
Practice Address - Country:US
Practice Address - Phone:860-714-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047434208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery