Provider Demographics
NPI:1790872893
Name:CAPORASO, GREGG LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:GREGG
Middle Name:LOUIS
Last Name:CAPORASO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 UNDERHILL AVE
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4557
Mailing Address - Country:US
Mailing Address - Phone:914-302-2140
Mailing Address - Fax:914-302-2276
Practice Address - Street 1:322 UNDERHILL AVE
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4557
Practice Address - Country:US
Practice Address - Phone:914-302-2140
Practice Address - Fax:914-302-2276
Is Sole Proprietor?:No
Enumeration Date:2006-10-09
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2023002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6X5821Medicare ID - Type Unspecified
NYH43479Medicare UPIN