Provider Demographics
NPI:1528072667
Name:CAPLIN, MITCHELL A (MD)
Entity type:Individual
Prefix:
First Name:MITCHELL
Middle Name:A
Last Name:CAPLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519W JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2619
Mailing Address - Country:US
Mailing Address - Phone:631-360-5900
Mailing Address - Fax:
Practice Address - Street 1:111 BROADWAY FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1995
Practice Address - Country:US
Practice Address - Phone:646-461-2544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212001207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
61Q551Medicare ID - Type Unspecified
G93122Medicare UPIN