Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | X011081 | NY |
NPI | 1003993106 |
---|---|
Provider Name | Thomas Francis Capolino |
First Address | Tarrytown, NY 10591-3456 |
Second Address | Glendale, NY 11385-7265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02723215 | (05) | NY |
V03227 | (02) | NY |