Provider Demographics
NPI:1639462344
Name:CAPELLE, DAVID P JR (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
Last Name:CAPELLE
Suffix:JR
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:88 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2519
Mailing Address - Country:US
Mailing Address - Phone:617-209-3844
Mailing Address - Fax:617-209-3845
Practice Address - Street 1:88 LEONARD ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2519
Practice Address - Country:US
Practice Address - Phone:617-209-3844
Practice Address - Fax:617-209-3845
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA5468156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician