Provider Demographics
NPI:1700090339
Name:CAPPELLO, JODI-ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:JODI-ANN
Middle Name:
Last Name:CAPPELLO
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 1:89 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-2610
Mailing Address - Country:US
Mailing Address - Phone:201-344-1660
Mailing Address - Fax:973-239-0921
Practice Address - Street 1:15 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-2700
Practice Address - Country:US
Practice Address - Phone:973-306-0043
Practice Address - Fax:973-239-0921
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXO11062- 5345110111N00000X
NJ38MC00642100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00642100OtherNJ STATE BOARD OF CHIROPRACTIC EXAMINERS
NYX0110062-1OtherNY STATE BOARD OF CHIROPRACTIC EXAMINERS