Organization
YOUR TRAVEL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAETANO CAPONE MD (PRESIDENT)
(215) 880-7272
Entity
Organization
Contact information
Practice address
847 YOUNGS FORD RD, GLADWYNE, PA 19035-1610
(215) 880-7090
Mailing address
PO BOX 523, BERWYN, PA 19312-0523
(215) 880-7090
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD023698E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285802353
—
PA
05
—
1669437604
—
PA
Enumeration date
02/06/2017
Last updated
02/06/2017
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