Provider Demographics
NPI:1063423374
Name:CAPOCCIA, MADHAVI (DO)
Entity type:Individual
Prefix:
First Name:MADHAVI
Middle Name:
Last Name:CAPOCCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MADHAVI
Other - Middle Name:K
Other - Last Name:MANIAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-1754
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:250 CETRONIA RD
Practice Address - Street 2:SUITE 115
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9147
Practice Address - Country:US
Practice Address - Phone:610-395-0307
Practice Address - Fax:610-395-0950
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201874207Q00000X
PAOS017383207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine