Provider Demographics
NPI:1598929044
Name:CAPISTRANO, CECILIA DORONILA (REGISTERED PT)
Entity Type:Individual
Prefix:MISS
First Name:CECILIA
Middle Name:DORONILA
Last Name:CAPISTRANO
Suffix:
Gender:F
Credentials:REGISTERED PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-2628
Mailing Address - Country:US
Mailing Address - Phone:914-328-0717
Mailing Address - Fax:
Practice Address - Street 1:621 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-2628
Practice Address - Country:US
Practice Address - Phone:914-637-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024099225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist