Provider Demographics
NPI:1538518717
Name:CARACAPPA, NICOLE
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:
Last Name:CARACAPPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MIRIAM ST APT 2
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1340
Mailing Address - Country:US
Mailing Address - Phone:516-361-4358
Mailing Address - Fax:
Practice Address - Street 1:8 MIRIAM ST APT 2
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1340
Practice Address - Country:US
Practice Address - Phone:516-361-4358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2018-10-04
Deactivation Date:2018-07-23
Deactivation Code:
Reactivation Date:2018-08-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist