Provider Demographics
NPI:1366521957
Name:CAPPAS, NYDIA M (PSYD)
Entity type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:M
Last Name:CAPPAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 PASEO FAGOT
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2303
Mailing Address - Country:US
Mailing Address - Phone:787-840-4460
Mailing Address - Fax:787-840-4069
Practice Address - Street 1:1484 PASEO FAGOT
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2303
Practice Address - Country:US
Practice Address - Phone:787-840-4460
Practice Address - Fax:787-840-4069
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2473103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical