Provider Demographics
NPI:1700827466
Name:CAPUANO, UMBERTO (MD)
Entity Type:Individual
Prefix:
First Name:UMBERTO
Middle Name:
Last Name:CAPUANO
Suffix:
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 1:70 KENYON AVE
Mailing Address - Street 2:UNIT 325
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4253
Mailing Address - Country:US
Mailing Address - Phone:401-792-7001
Mailing Address - Fax:401-792-7085
Practice Address - Street 1:70 KENYON AVE
Practice Address - Street 2:UNIT 325
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4253
Practice Address - Country:US
Practice Address - Phone:401-792-7001
Practice Address - Fax:401-792-7085
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07065208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9002039Medicaid
RIC90580Medicare UPIN