Provider Demographics
NPI:1790053882
Name:ANTHONY CAPIZZI, MD, PC
Entity Type:Organization
Organization Name:ANTHONY CAPIZZI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PC
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPIZZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:631-669-3700
Mailing Address - Street 1:786 MONTAUK HWY
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4926
Mailing Address - Country:US
Mailing Address - Phone:631-669-3700
Mailing Address - Fax:631-669-0222
Practice Address - Street 1:786 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4926
Practice Address - Country:US
Practice Address - Phone:631-669-3700
Practice Address - Fax:631-669-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159239208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61751Medicare UPIN