Provider Demographics
NPI:1538835707
Name:CAPTEUM HEALTH CARE
Entity type:Organization
Organization Name:CAPTEUM HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNACCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-435-6724
Mailing Address - Street 1:110 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:POINT LOOKOUT
Mailing Address - State:NY
Mailing Address - Zip Code:11569-3029
Mailing Address - Country:US
Mailing Address - Phone:516-695-8961
Mailing Address - Fax:
Practice Address - Street 1:255 STATE RT 3 STE 104E
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3857
Practice Address - Country:US
Practice Address - Phone:973-435-6724
Practice Address - Fax:973-435-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty