Provider Demographics
NPI:1982781209
Name:CAPO, JOHN THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:CAPO
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 1:377 JERSEY AVE
Mailing Address - Street 2:SUITE 280A
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4393
Mailing Address - Country:US
Mailing Address - Phone:201-716-5851
Mailing Address - Fax:201-309-2432
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:SUITE 280A
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-716-5851
Practice Address - Fax:201-309-2432
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07183000207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8460400Medicaid
NJ8460400Medicaid
NJ045718Medicare PIN