Healthcare Provider Details

I. General information

NPI: 1972437663
Provider Name (Legal Business Name): GABRIELA ELIZABETH MATOS CAMPOS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL
NEW BRUNSWICK NJ
08901-1928
US

IV. Provider business mailing address

1 INDEPENDENCE PL
SOUTH RIVER NJ
08882-2709
US

V. Phone/Fax

Practice location:
  • Phone: 347-721-4110
  • Fax:
Mailing address:
  • Phone: 347-721-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number352790
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15586200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: