Provider Demographics
NPI:1093926271
Name:CAPITANI, TERESA V (RPH)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:V
Last Name:CAPITANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-1828
Mailing Address - Country:US
Mailing Address - Phone:716-372-0588
Mailing Address - Fax:
Practice Address - Street 1:2801 W STATE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1828
Practice Address - Country:US
Practice Address - Phone:716-373-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-27
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032263183500000X
FLPS22293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist