Provider Demographics
NPI:1730542341
Name:CAPUTO, NICOLLETTE (NP)
Entity type:Individual
Prefix:
First Name:NICOLLETTE
Middle Name:
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 BROOME ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3569
Mailing Address - Country:US
Mailing Address - Phone:646-823-1611
Mailing Address - Fax:646-871-6820
Practice Address - Street 1:440 BROOME ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3569
Practice Address - Country:US
Practice Address - Phone:468-231-6116
Practice Address - Fax:646-871-6820
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340480363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner