Provider Demographics
NPI:1285235374
Name:CAPUANO, PAUL HENRY
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:HENRY
Last Name:CAPUANO
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 1:1 PARDONS WOOD LN
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1446
Mailing Address - Country:US
Mailing Address - Phone:401-580-8281
Mailing Address - Fax:401-383-7773
Practice Address - Street 1:1 PARDONS WOOD LN
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1446
Practice Address - Country:US
Practice Address - Phone:401-580-8281
Practice Address - Fax:401-383-7773
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH2859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist