Provider Demographics
NPI:1508878612
Name:CAPUTO-FOX, BARBARA A (OD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:CAPUTO-FOX
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MIFFLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503
Mailing Address - Country:US
Mailing Address - Phone:570-342-3145
Mailing Address - Fax:570-344-1309
Practice Address - Street 1:200 MIFFLIN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1982
Practice Address - Country:US
Practice Address - Phone:570-342-3145
Practice Address - Fax:570-403-3062
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG001066152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410033982OtherRAILROAD MEDICARE
PA001259774Medicaid
CA578933OtherHIGH MARK BLUE SHIELD
506554OtherAETNA
6953OtherGEISINGER HEALTH PLAN
811738OtherFIRST PRIORITY HEALTH
506554OtherAETNA
PA578933Medicare ID - Type Unspecified