Healthcare Provider Details

I. General information

NPI: 1538151147
Provider Name (Legal Business Name): DIANE MARIE HILAL-CAMPO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 YAWPO AVE SUITE 1
OAKLAND NJ
07436-2714
US

IV. Provider business mailing address

43 YAWPO AVE STE 1
OAKLAND NJ
07436-2717
US

V. Phone/Fax

Practice location:
  • Phone: 201-337-9300
  • Fax: 201-405-0558
Mailing address:
  • Phone: 201-337-9300
  • Fax: 201-405-0558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA06404700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number25MA06404700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: