Provider Demographics
NPI:1659338564
Name:CAPONIGRO, JOHN JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:CAPONIGRO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BROADWAY
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407
Mailing Address - Country:US
Mailing Address - Phone:201-794-3223
Mailing Address - Fax:201-794-8411
Practice Address - Street 1:67 BROADWAY
Practice Address - Street 2:1ST FLOOR
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407
Practice Address - Country:US
Practice Address - Phone:201-794-3223
Practice Address - Fax:201-794-8411
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002533213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP0054008WOtherWORKER'S COMP
NJ264417700OtherWORKER'S COMP
NJP2173631OtherOXFORD
NJ480032319OtherRAILROAD MEDICARE
NY01912789Medicaid
NYP2104038OtherOXFORD
NJP2173631OtherOXFORD
NJU72947Medicare UPIN
NJ35759Medicare ID - Type Unspecified