Basic Information
| Provider Information | |||||||||
| NPI: | 1609042134 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GORDON-CAPPITELLI | ||||||||
| FirstName: | JUDIT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 418283 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 022418283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024443700 | ||||||||
| FaxNumber: | 2024447304 | ||||||||
| Practice Location | |||||||||
| Address1: | 3800 RESERVOIR RD NW | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200072113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2024443700 | ||||||||
| FaxNumber: | 2024447304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2008 | ||||||||
| LastUpdateDate: | 03/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT186636 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD040407 | DC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | MD040407 | DC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.