Provider Demographics
NPI:1386615003
Name:CAPOOCIA, AMY BETH (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:BETH
Last Name:CAPOOCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2946 CONESTOGA RD
Mailing Address - Street 2:
Mailing Address - City:GLENMOORE
Mailing Address - State:PA
Mailing Address - Zip Code:19343-9516
Mailing Address - Country:US
Mailing Address - Phone:484-202-0807
Mailing Address - Fax:484-930-0573
Practice Address - Street 1:2946 CONESTOGA RD
Practice Address - Street 2:
Practice Address - City:GLENMOORE
Practice Address - State:PA
Practice Address - Zip Code:19343-9516
Practice Address - Country:US
Practice Address - Phone:484-202-0807
Practice Address - Fax:484-930-0573
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 9782207Q00000X
PAOS013204207Q00000X
FLOS9782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8329YMedicare PIN
FLU8329VMedicare PIN
FLU8329XMedicare PIN
FLU8329WMedicare PIN