Provider Demographics
NPI:1609962240
Name:LOUIS F D'AMELIO
Entity Type:Organization
Organization Name:LOUIS F D'AMELIO
Other - Org Name:CAPITAL SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AMELIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-396-2600
Mailing Address - Street 1:PO BOX 8500-7211
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:609-396-2600
Mailing Address - Fax:609-396-3600
Practice Address - Street 1:40 FULD STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08638
Practice Address - Country:US
Practice Address - Phone:609-396-2600
Practice Address - Fax:609-396-3600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA548932086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8398101Medicaid
NJ039941N9PMedicare PIN