Individual
MARY ELLEN CAPUANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 SAVANNAH RD, LEWES, DE 19958-1462
(302) 645-3300
Mailing address
PO BOX 788, POMONA, NJ 08240-0788
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
626179
NJ
2085R0204X
Vascular & Interventional Radiology Physician
626179
NJ
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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