Healthcare Provider Details

I. General information

NPI: 1063583250
Provider Name (Legal Business Name): THOMAS CAMPIONE APN-C, DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 COUNTY RD SUITE 2A
CRESSKILL NJ
07626-2203
US

IV. Provider business mailing address

135 COUNTY RD SUITE 2A
CRESSKILL NJ
07626-2203
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-0500
  • Fax: 201-569-5561
Mailing address:
  • Phone: 201-569-0500
  • Fax: 201-569-5561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number38MC00524400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ00816800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: