Provider Demographics
NPI:1720015126
Name:KAPNER, LOUIS B (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:B
Last Name:KAPNER
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 1:1850 BRIGHTON HENRIETTA TOWN LINE RD
Mailing Address - Street 2:C/O CREDENTIALING DEPARTMENT
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2532
Mailing Address - Country:US
Mailing Address - Phone:585-452-8114
Mailing Address - Fax:585-452-8111
Practice Address - Street 1:800 CARTER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-2604
Practice Address - Country:US
Practice Address - Phone:585-338-1200
Practice Address - Fax:585-544-1359
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133242207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01252157Medicaid
NYJ400014215Medicare PIN
NYB74822Medicare UPIN
NY01252157Medicaid
NYIA1250Medicare PIN