Provider Demographics
NPI:1972282325
Name:CAPUTO, DOMINIC JOSEPH
Entity type:Individual
Prefix:
First Name:DOMINIC
Middle Name:JOSEPH
Last Name:CAPUTO
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 1:515 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-8003
Mailing Address - Country:US
Mailing Address - Phone:570-971-4510
Mailing Address - Fax:
Practice Address - Street 1:432 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-1135
Practice Address - Country:US
Practice Address - Phone:570-484-2027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer