Park Avenue Primary Medical

LBN: Domiciano V. Capitly, M.D.
Park Avenue Primary Medical is an health care organization with primary practice located at 1907 Park Ave Suite 203, South Plainfield NJ 07080-5530. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Domiciano V. Capitly, M.D. can be contacted via phone (908) 561-3934, or through Capitly, Domiciano V via phone (908) 561-3934.

Contact Information

Primary practice address
1907 Park Ave Suite 203 South Plainfield NJ 07080-5530
Phone: (908) 561-3934
Fax: (908) 561-6881
Website:
Map and Directions
Authorized official contact:
Name: Capitly, Domiciano V Doctor of Medicine (MD)
Phone: (908) 561-3934

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1609087451
LBN Legal business name Domiciano V. Capitly, M.D.
DBA Doing business as Park Avenue Primary Medical
Authorized official Capitly, Domiciano V Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 24th, 2007
Last updated Oct 11th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609087451 NPPES
New Jersey MEDICAID 0722804

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