Provider Demographics
NPI:1699100115
Name:CAPILA, RONALD A (RN)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:CAPILA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1801
Mailing Address - Country:US
Mailing Address - Phone:973-960-5136
Mailing Address - Fax:
Practice Address - Street 1:177 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1801
Practice Address - Country:US
Practice Address - Phone:973-960-5136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY503577163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse