MEDICARE: SANDY CAMPOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	727998-01	NY
2	163WL0100X	Lactation Consultant (Registered Nurse)	L-320660	NY

General Provider Information

NPI Number	:	1346107968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY CAMPOS

Provider Business Mailing Address
First Line	:	473 BOHEMIA PKWY
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-3301
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	473 BOHEMIA PKWY
Second Line	:
City	:	SAYVILLE
State	:	NY
Zip	:	11782-3301
Country	:	US
Telephone Number	:	516-724-6307
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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Directions to “ SANDY CAMPOS ” Practice Location

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