Healthcare Provider Details
I. General information
NPI: 1609968676
Provider Name (Legal Business Name): RICHARD P CAMPO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/28/2006
Last Update Date: 03/22/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
277 FOREST AVE SUITE 206
PARAMUS NJ
07652
US
IV. Provider business mailing address
1 DIAMOND HILL RD
BERKELEY HEIGHTS NJ
07922-2104
US
V. Phone/Fax
- Phone: 201-489-8900
- Fax: 201-489-0877
- Phone: 908-273-4300
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | 25MA06409300 |
| License Number State | NJ |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 10203 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | MEDICHOICE |
| # 2 | |
| Identifier | 971867 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | FIRST HEALTH |
| # 3 | |
| Identifier | 1000752 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | GHI |
| # 4 | |
| Identifier | 2984400 012 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | CIGNA |
| # 5 | |
| Identifier | 340016986 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | RAIL ROAD |
| # 6 | |
| Identifier | 366167 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | PHCS |
| # 7 | |
| Identifier | 1434931 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | UNITED HEALTHCARE |
| # 8 | |
| Identifier | P414450 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | OXFORD |
| # 9 | |
| Identifier | 1K 2196 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | HEALTHNET |
| # 10 | |
| Identifier | 1K 2196 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | PHS |
| # 11 | |
| Identifier | 2158585 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | AETNA |
| # 12 | |
| Identifier | 31764 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | MASTERCARE |
| # 13 | |
| Identifier | 58121705 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | MULTIPLAN |
| # 14 | |
| Identifier | 22742 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | UNIVERSITY |
| # 15 | |
| Identifier | 82L75 1 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | EMPIRE |
| # 16 | |
| Identifier | 7059205 |
| Identifier Type | MEDICAID |
| Identifier State | NJ |
| Identifier Issuer | |
| # 17 | |
| Identifier | 82L75 1 |
| Identifier Type | OTHER |
| Identifier State | NJ |
| Identifier Issuer | WELLCHOICE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
