Basic Information
| Provider Information | |||||||||
| NPI: | 1295162865 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAPITAL REGION UROLOGICAL SURGEONS, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 WEST AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128666045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185830111 | ||||||||
| FaxNumber: | 5185832426 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 WEST AVE | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | SARATOGA SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128666045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185830111 | ||||||||
| FaxNumber: | 5185832426 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2013 | ||||||||
| LastUpdateDate: | 09/27/2013 | ||||||||
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| AuthorizedOfficialLastName: | CAPELLO | ||||||||
| AuthorizedOfficialFirstName: | SETH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | MD/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5185830111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.