Provider Demographics
NPI:1831624279
Name:KAPUR, VINOD (DPT)
Entity type:Individual
Prefix:
First Name:VINOD
Middle Name:
Last Name:KAPUR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SADDLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2518
Mailing Address - Country:US
Mailing Address - Phone:516-790-0114
Mailing Address - Fax:
Practice Address - Street 1:11915 ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-1970
Practice Address - Country:US
Practice Address - Phone:718-634-3211
Practice Address - Fax:718-634-0926
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041340225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist