Provider Demographics
NPI:1609042134
Name:GORDON-CAPPITELLI, JUDIT (MD)
Entity type:Individual
Prefix:
First Name:JUDIT
Middle Name:
Last Name:GORDON-CAPPITELLI
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 1:2445 ARMY NAVY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2988
Mailing Address - Country:US
Mailing Address - Phone:814-360-1593
Mailing Address - Fax:703-998-6821
Practice Address - Street 1:2445 ARMY NAVY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2988
Practice Address - Country:US
Practice Address - Phone:814-360-1593
Practice Address - Fax:703-998-6821
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT186636207R00000X
DCMD040407207R00000X, 207RN0300X
VA0101269874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA126811Medicare PIN