Provider Demographics
NPI:1750548194
Name:JOSEPH M CAPO MD PC
Entity type:Organization
Organization Name:JOSEPH M CAPO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMIEUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-731-6644
Mailing Address - Street 1:333 GLEN HEAD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-1947
Mailing Address - Country:US
Mailing Address - Phone:516-671-5511
Mailing Address - Fax:516-671-5210
Practice Address - Street 1:333 GLEN HEAD RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-1947
Practice Address - Country:US
Practice Address - Phone:516-671-5511
Practice Address - Fax:516-671-5210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW86922Medicare PIN