Organization · NPI-2

Paul Capobianco, DO, P.C.

Family Medicine · Glen Cove, NY

NPI number1669038360

StatusActive

Last updated in NPPESMay 17, 2019

Details

NPI: 1669038360
Entity type: Organization (NPI-2)
Legal business name: Paul Capobianco, DO, P.C.
Organization subpart: No
Enumeration date: May 17, 2019
Last updated: May 17, 2019

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	–	–	Yes
175L00000X	Homeopath	–	–
204D00000X	Neuromusculoskeletal Medicine & OMM	–	–

Practice location

71 Walnut Rd
Glen Cove, NY 11542-2634

Phone 516-671-5017 · Fax 516-671-5083

Mailing address

71 Walnut Rd
Glen Cove, NY 11542-2634

Phone 516-671-5017 · Fax 516-671-5083

Authorized official

Paul Capobianco
President
5166715017

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