Provider Demographics
NPI:1588700983
Name:CAPPELMANN, ERIN NICOLE
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:NICOLE
Last Name:CAPPELMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2726
Mailing Address - Country:US
Mailing Address - Phone:631-365-4799
Mailing Address - Fax:
Practice Address - Street 1:267 6TH ST
Practice Address - Street 2:
Practice Address - City:SAINT JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2726
Practice Address - Country:US
Practice Address - Phone:631-365-4799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor