Individual provider · NPI-1

John David Capobianco, D.O.

Family Medicine · Glen Cove, NY

NPI number1245267970
StatusActive
Last updated in NPPESJun 6, 2008

Details

NPI
1245267970
Entity type
Individual (NPI-1)
Name
John David Capobianco
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 27, 2006
Last updated
Jun 6, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine182685-1NYYes
204D00000X Neuromusculoskeletal Medicine & OMM182685-1NY
208D00000X General Practice182685-1NY

Practice location

20 Landing Rd
Glen Cove, NY 11542-2414

Phone 516-676-5005

Mailing address

21 Club Rd
Sea Cliff, NY 11579-2121

Phone 516-676-5005

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