| Doctor Name: | DR. CARL WILLIAM CAPPELLO |
| NPI Number: | 1063606424 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DOCTOR OF DIVINITY |
| License Number: | |
| Business Practice Address: | 144 4th Ave Bay Shore, NY - 117067900 |
| Business Phone Number: | 6316656244 |
| Business Fax Number: | 6319686169 |
| Mailing Address: | 144 4th Ave, BAY SHORE |
| State: | NY |
| Postal Code: | 117067900 |
| Phone Number: | 6316656244 |
| Fax Number: | 6319686169 |
| NPI Enumeration Date: | 08/29/2007 |
| NPI Last Update Date: | 08/29/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP1600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Pastoral |
| Taxonomy Definition: | |