Domiciano V. Capitly, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DOMICIANO V. CAPITLY, M.D.

Practice address

1907 Park Ave
Suite 203
South Plainfield, NJ 07080-5530

Phone

(908) 561-3934

Fax

(908) 561-6881

NPI assigned

May 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Domiciano V Capitly, M.D.

Title

Medical Doctor

Phone

(908) 561-3934

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Park Avenue Primary Medical Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1609087451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 PARK AVE",
            "address_2": "SUITE 203",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805530",
            "telephone_number": "908-561-3934",
            "fax_number": "908-561-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 PARK AVE",
            "address_2": "SUITE 203",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805530",
            "telephone_number": "908-561-3934",
            "fax_number": "908-561-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMICIANO V. CAPITLY, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "CAPITLY",
        "authorized_official_first_name": "DOMICIANO",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "908-561-3934",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0722804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Avenue Primary Medical",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Dietrich, DPT, ATC
• Kathleen Dillon, RPH
• Jeremy Scott Dinkin, DC
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• Diane Dohn, RPH
• Nripen Chakravarthy Dontineni, M.D
• Arvind K Doshi, M.D.
• Dr Jays Clinic LLC
• Dr. Gutierrez Chiropractic and Health Center LLC,
• Drug Fair Group, Inc.

• Internal Medicine Physician in South Plainfield, NJ
• Providers in South Plainfield, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.