Basic Information
| Provider Information | |||||||||
| NPI: | 1528007374 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAPUTO | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | VERONICA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | B.S. PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 38 HILLTOP DR | ||||||||
| Address2: | |||||||||
| City: | SHAVERTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187089659 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 E END BLVD | ||||||||
| Address2: | |||||||||
| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187110030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708243521 | ||||||||
| FaxNumber: | 5708195143 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT006627L | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.