Provider Demographics
NPI:1851715221
Name:CAPCOR NEURODIAGNOSTICS
Entity Type:Organization
Organization Name:CAPCOR NEURODIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPUANA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-542-2782
Mailing Address - Street 1:14 KELLOGG RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2825
Mailing Address - Country:US
Mailing Address - Phone:315-542-2782
Mailing Address - Fax:
Practice Address - Street 1:14 KELLOGG RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2825
Practice Address - Country:US
Practice Address - Phone:315-542-2782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic NeuroimagingGroup - Single Specialty