Provider Demographics
NPI:1659652063
Name:CAPUTO, JENNA SUSANNE (OTR)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:SUSANNE
Last Name:CAPUTO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 REID AVE
Mailing Address - Street 2:
Mailing Address - City:BREEZY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1218
Mailing Address - Country:US
Mailing Address - Phone:917-692-2710
Mailing Address - Fax:
Practice Address - Street 1:11 REID AVE
Practice Address - Street 2:
Practice Address - City:BREEZY POINT
Practice Address - State:NY
Practice Address - Zip Code:11697-1218
Practice Address - Country:US
Practice Address - Phone:917-692-2710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics