Provider Demographics
NPI:1790243863
Name:KAPATOES, SUSAN (MHA, CPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:KAPATOES
Suffix:
Gender:F
Credentials:MHA, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CONSTITUTION CT APT 119
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2916
Mailing Address - Country:US
Mailing Address - Phone:508-282-7877
Mailing Address - Fax:
Practice Address - Street 1:5 CONSTITUTION CT APT 119
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-2916
Practice Address - Country:US
Practice Address - Phone:508-282-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies