Provider Demographics
NPI:1851702351
Name:CAPOZZOLI, MARY (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:CAPOZZOLI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1475 MOUNT HOLLY RD APT H10
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08010-2226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1475 MOUNT HOLLY RD APT H10
Practice Address - Street 2:
Practice Address - City:EDGEWATER PARK
Practice Address - State:NJ
Practice Address - Zip Code:08010-2226
Practice Address - Country:US
Practice Address - Phone:609-760-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN047729163W00000X
CA636205163W00000X
DCRN66224163W00000X
FLRN9282143163W00000X
MERN57262163W00000X
MDR180104163W00000X
MARN279887163W00000X
MI4704224890163W00000X
NY522416163W00000X
PARN262754L163W00000X
TX790139163W00000X
VA0001085054163W00000X
WARN60049824163W00000X
NJ26NO07003600163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163W00000XNursing Service ProvidersRegistered Nurse