Provider Demographics
NPI:1790781375
Name:VALENTIN-CAPELES, NEYSA I (DO)
Entity Type:Individual
Prefix:MS
First Name:NEYSA
Middle Name:I
Last Name:VALENTIN-CAPELES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 BEACH 19TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4423
Mailing Address - Country:US
Mailing Address - Phone:516-400-9302
Mailing Address - Fax:516-400-9309
Practice Address - Street 1:275 ROCKAWAY TPKE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559
Practice Address - Country:US
Practice Address - Phone:516-400-9302
Practice Address - Fax:516-400-9309
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202814-1208600000X
NY2028142086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02076117Medicaid
H13942Medicare UPIN
NY02076117Medicaid