Provider Demographics
NPI:1558580811
Name:CAPORELLO, EDWARD ANTHONY (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ANTHONY
Last Name:CAPORELLO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CRESTVIEW TER
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2203
Mailing Address - Country:US
Mailing Address - Phone:603-772-2786
Mailing Address - Fax:
Practice Address - Street 1:2 COLLEGE PARK DR
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1636
Practice Address - Country:US
Practice Address - Phone:603-268-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2359183500000X
MA19467183500000X
NHR1010183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist