Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MA56226 | NJ |
NPI | 1447284450 |
---|---|
Provider Name | Deborah Marie Capko |
First Address | New York, NY 10017-6706 |
Second Address | Basking Ridge, NJ 07920-3444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 25/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7220405 | (05) | NJ |
75-3125078 | FEDERAL TAX ID (01) | NJ |
G26364 | (02) | NJ |