Provider Demographics
NPI:1386902047
Name:CAPITOL MEDICAL SOLUTIONS NY, LLC
Entity type:Organization
Organization Name:CAPITOL MEDICAL SOLUTIONS NY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BONVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-335-2296
Mailing Address - Street 1:253 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-1111
Mailing Address - Country:US
Mailing Address - Phone:585-335-2296
Mailing Address - Fax:585-335-2299
Practice Address - Street 1:253 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1111
Practice Address - Country:US
Practice Address - Phone:585-335-2296
Practice Address - Fax:585-335-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145372207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty