Basic Information
| Provider Information | |||||||||
| NPI: | 1639237415 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAPPELLI | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | P.T. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ALCURI | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 24 CROFT RD | ||||||||
| Address2: | |||||||||
| City: | NEW HARTFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134132622 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 E CHESTNUT ST | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | ROME | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134402834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3153377952 | ||||||||
| FaxNumber: | 3153370991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 08/30/2018 | ||||||||
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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 | 225100000X | 028591-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.