Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD025510E | PA |
N | 208600000X | Surgeon | MD025510E | PA |
N | 2082S0105X | Plastic Hand Surgeon | MD025510E | PA |
Y | 2086S0105X | Surgery of the Hand | MD025510E | PA |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD025510E | PA |
NPI | 1649377474 |
---|---|
Provider Name | Raymond A Capone JR. |
First Address | Pittsburgh, PA 15206-3707 |
Second Address | Pittsburgh, PA 15206-3707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 20/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009448280003 | (05) | PA |
C34237 | (02) | PA |