Basic Information
Provider Information
NPI: 1881846749
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAPORALETTI
FirstName: MICHELLE
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 223 WILMINGTON W CHESTER PIKE STE 214
Address2:  
City: CHADDS FORD
State: PA
PostalCode: 193179007
CountryCode: US
TelephoneNumber: 8443657246
FaxNumber: 6103617956
Practice Location
Address1: 300 WELSH RD STE 104
Address2:  
City: HORSHAM
State: PA
PostalCode: 190442248
CountryCode: US
TelephoneNumber: 8443657246
FaxNumber: 8445160080
Other Information
ProviderEnumerationDate: 10/22/2008
LastUpdateDate: 10/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207LP2900XOS014579PAN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
208VP0000XOS014579PAY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine

No ID Information.


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