Provider Demographics
NPI:1053679431
Name:CAPOBIANCO, ALESSANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:CAPOBIANCO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 CHAPEL ST
Mailing Address - Street 2:NEMG - YNH GERIATRIC SERVICES
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4405
Mailing Address - Country:US
Mailing Address - Phone:203-688-8200
Mailing Address - Fax:203-688-8204
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:NEMG - YNH GERIATRIC SERVICES
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-688-8200
Practice Address - Fax:203-688-8204
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT55077207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1053679431OtherCONNECTICARE
CT0982346OtherCIGNA
CT1053679431Medicaid
CT1474140OtherWELLCARE
CT4950610OtherAETNA
CT3082578OtherCOVENTRY
CT1053679431OtherMULTIPLAN
CT1053679431OtherANTHEM
CT1053679431OtherUNITED HEALTHCARE
CTAA562455OtherHARVARD PILGRIM
CTP5755157OtherOXFORD