Provider Demographics
NPI:1619289980
Name:CAPEZZUTO, BREE
Entity Type:Individual
Prefix:
First Name:BREE
Middle Name:
Last Name:CAPEZZUTO
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 1:1097 BUSHY RUN RD
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3804
Mailing Address - Country:US
Mailing Address - Phone:412-417-3059
Mailing Address - Fax:
Practice Address - Street 1:4927 HOMEVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2956
Practice Address - Country:US
Practice Address - Phone:412-469-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441277183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist