Basic Information
| Provider Information | |||||||||
| NPI: | 1730193897 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAPPETTA | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 SOUTHWOOD DR | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - PEDIATRICS | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035774400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2300 SOUTHWOOD DR | ||||||||
| Address2: | DARTMOUTH HITCHCOCK - PEDIATRICS | ||||||||
| City: | NASHUA | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035774400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 8886 | NH | N | Allopathic & Osteopathic Physicians | General Practice | 208000000X | 8886 | NH | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.