Provider Demographics
NPI:1578617361
Name:CAPULE, MARYLEE (PT)
Entity Type:Individual
Prefix:
First Name:MARYLEE
Middle Name:
Last Name:CAPULE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 HIGHWAY 35 STE 205
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5934
Mailing Address - Country:US
Mailing Address - Phone:732-530-7700
Mailing Address - Fax:732-530-7701
Practice Address - Street 1:225 HIGHWAY 35 STE 205
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5934
Practice Address - Country:US
Practice Address - Phone:732-530-7700
Practice Address - Fax:732-530-7701
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPTQA01152600225100000X
NJ40QA01152600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1730508789OtherNPI 2