Provider Demographics
NPI:1891250494
Name:KAPA, PAUL TATA (RN)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:TATA
Last Name:KAPA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22400 BUTTERFIELD RD APT 212
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1901
Mailing Address - Country:US
Mailing Address - Phone:708-769-6574
Mailing Address - Fax:
Practice Address - Street 1:22400 BUTTERFIELD RD APT 212
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1901
Practice Address - Country:US
Practice Address - Phone:708-769-6574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health