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Organization
MOHAWK VALLEY PODIATRY PC
Active
Organization
MOHAWK VALLEY PODIATRY PC
Active
Other names
Dr Robert C DiCaprio, Jr
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CARL DICAPRIO JR. DPM (OWNER/PRACTITIONER)
(518) 853-3999
Entity
Organization
Contact information
Practice address
19 MAIN ST, FULTONVILLE, NY 12072-0427
(518) 853-3999
(518) 374-1818
Mailing address
PO BOX 427, FULTONVILLE, NY 12072-0427
(518) 853-3999
(518) 374-1818
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004755
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000448056003
BLUE SHIELD
NY
05
—
01554094
—
NY
01
—
10000492
CDPHP
—
01
—
54134
MVP
—
01
—
P114421
BLUE CROSS
NY
Enumeration date
08/31/2006
Last updated
12/10/2019
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