1215011895 NPI number — CAPUTO FOOT & ANKLE CTRS

Table of content: (NPI 1215011895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215011895 NPI number — CAPUTO FOOT & ANKLE CTRS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPUTO FOOT & ANKLE CTRS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
PATRICK J. CAPUTO, DPM
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215011895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 N BEERS ST
Provider Second Line Business Mailing Address:
SUITE 2A
Provider Business Mailing Address City Name:
HOLMDEL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07733-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-739-3230
Provider Business Mailing Address Fax Number:
732-739-4656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
719 N BEERS ST
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
HOLMDEL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07733-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-739-3230
Provider Business Practice Location Address Fax Number:
732-739-4656
Provider Enumeration Date:
10/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAPUTO
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PODIATRIST DOCTOR
Authorized Official Telephone Number:
732-739-3230

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  25MD00146300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)