Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 001249 | CT |
N | 111NS0005X | Chiropractic Sports Physician | 008848 | NY |
NPI | 1205030814 |
---|---|
Provider Name | Dr. Jill M Capalbo |
First Address | Cos Cob, CT 06807-2111 |
Second Address | Stamford, CT 06905-5100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 08/07/2007 |