Provider Demographics
NPI:1245860626
Name:CAPOANO, DENISE MARY (RDN)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:MARY
Last Name:CAPOANO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2058
Mailing Address - Country:US
Mailing Address - Phone:908-477-5024
Mailing Address - Fax:
Practice Address - Street 1:91 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2058
Practice Address - Country:US
Practice Address - Phone:908-477-5024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1102266133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1102266OtherACADEMY OF NUTRITION AND DIETETICS