Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 042-0006511 | VT |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 042-0006511 | VT |
NPI | 1083646749 |
---|---|
Provider Name | Dr. Eleanor Lacava Capeless |
First Address | South Burlington, VT 05403-7880 |
Second Address | Burlington, VT 05401-1473 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0005158 | (05) | VT |
00689010 | NY MEDICAID (01) | NY |
B85511 | (02) | VT |