Basic Information
Provider Information
NPI: 1366095481
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPISTRANO
FirstName: MARIA CHRISTINA
MiddleName: MUSNI
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 455 TOLL GATE RD
Address2:  
City: WARWICK
State: RI
PostalCode: 028862770
CountryCode: US
TelephoneNumber: 4017377000
FaxNumber:  
Practice Location
Address1: 455 TOLL GATE RD
Address2:  
City: WARWICK
State: RI
PostalCode: 028862770
CountryCode: US
TelephoneNumber: 4017377000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/17/2019
LastUpdateDate: 08/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XLP04728RIY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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