Provider Demographics
NPI:1972683803
Name:CAPORIN, JACQUELINE JONES (DC)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:JONES
Last Name:CAPORIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1190
Mailing Address - Country:US
Mailing Address - Phone:610-670-6070
Mailing Address - Fax:
Practice Address - Street 1:3414 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1190
Practice Address - Country:US
Practice Address - Phone:610-670-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003794L111N00000X
MD01426111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02603400OtherCAPITAL BLUE CROSS ID
PACA148921OtherHIGHMARK PROVIDER ID
PACA148921OtherHIGHMARK PROVIDER ID
PAU45018Medicare UPIN