Provider Demographics
NPI:1801837620
Name:CAPPIELLO, CYNTHIA THERESA (NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:THERESA
Last Name:CAPPIELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611-1396
Mailing Address - Country:US
Mailing Address - Phone:585-368-4500
Mailing Address - Fax:585-436-6047
Practice Address - Street 1:158 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-1396
Practice Address - Country:US
Practice Address - Phone:585-368-4500
Practice Address - Fax:585-436-6047
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02388269Medicaid
NYJ400052616/GP BA0017Medicare PIN
NYJ400052617/GP 70008AMedicare PIN