Provider Demographics
NPI:1457899718
Name:CAPOLUPO, ANDREA (MS)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:CAPOLUPO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 KNOLLS CRESCENT
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10463
Mailing Address - Country:US
Mailing Address - Phone:917-846-9475
Mailing Address - Fax:
Practice Address - Street 1:55 KNOLLS CRES
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-6331
Practice Address - Country:US
Practice Address - Phone:917-846-9475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool