Provider Demographics
NPI:1134423007
Name:KAPPLER, GUSTAV E III (MD)
Entity type:Individual
Prefix:
First Name:GUSTAV
Middle Name:E
Last Name:KAPPLER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#688 MC KAY RD
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7424
Mailing Address - Country:US
Mailing Address - Phone:518-842-8497
Mailing Address - Fax:518-842-8497
Practice Address - Street 1:#688 MC KAY RD.
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7424
Practice Address - Country:US
Practice Address - Phone:518-842-8497
Practice Address - Fax:518-842-8497
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100880-1208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery