Provider Demographics
NPI:1770024135
Name:KAPTAINE, ZACHARY
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:KAPTAINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 HARMONY LN
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-6944
Mailing Address - Country:US
Mailing Address - Phone:954-235-0063
Mailing Address - Fax:
Practice Address - Street 1:96 HARMONY LN
Practice Address - Street 2:
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-6944
Practice Address - Country:US
Practice Address - Phone:954-235-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer