Individual
DR. LESLIE CAPULONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 283-1234
Mailing address
5776 GRAPE RD STE 51, PMB 190, MISHAWAKA, IN 46545-8460
(347) 504-0301
(201) 733-1176
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01096917A
IN
2084P0800X
Psychiatry Physician
Primary
325281
NY
Other
Enumeration date
03/25/2020
Last updated
07/17/2025
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