Individual
MR. CHARLES J CAPACI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1240 S BROAD ST STE 200, LANSDALE, PA 19446-5395
(215) 361-3376
(215) 412-3587
Mailing address
455 PENNSYLVANIA AVE STE 127, FORT WASHINGTON, PA 19034-3409
(215) 793-9755
(215) 793-4974
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA054469
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA054469
PA STATE LICENCE
PA
Enumeration date
07/30/2010
Last updated
08/20/2020
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