Provider Demographics
NPI:1518571215
Name:CAPUTO, NANCY (LMT CPT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:LMT CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1040
Mailing Address - Country:US
Mailing Address - Phone:516-850-3433
Mailing Address - Fax:
Practice Address - Street 1:289 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1040
Practice Address - Country:US
Practice Address - Phone:516-850-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015646225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY015646OtherNYS LICENSE