Provider Demographics
NPI:1124464201
Name:CAPUTO, GINA M (DO)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 STANTON CHRISTIANA RD STE 207
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2148
Mailing Address - Country:US
Mailing Address - Phone:302-633-7550
Mailing Address - Fax:302-225-3774
Practice Address - Street 1:537 STANTON CHRISTIANA RD STE 207
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-633-7550
Practice Address - Fax:302-225-3774
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA390200000X
DEC2-0012122207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program