Provider Demographics
NPI:1063142313
Name:CAPORUSCIO, PAUL
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:CAPORUSCIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12910 SCHREIBER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5432
Mailing Address - Country:US
Mailing Address - Phone:440-292-6256
Mailing Address - Fax:
Practice Address - Street 1:12910 SCHREIBER RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44125-5432
Practice Address - Country:US
Practice Address - Phone:440-292-6256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care