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NPI 1508821638

NPI 1508821638 : ANGELO JOSEPH CAMPAGNA M.D. : LOCKPORT, NY

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General NPI Number Information
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    NPI Number           |    1508821638
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    Entity Type          |    Individual 
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    Provider Name        |    ANGELO JOSEPH CAMPAGNA M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/20/2006
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    Last Update Date     |    10/10/2011
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Provider Practice Location Address
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    Address Line         |    ULRICH CITY CENTRE SUITE 7
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094-5368
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    Country              |    US
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    Telephone            |    716-433-1941
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    Fax                  |    716-439-1233
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Provider Business Mailing Address
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    Address Line         |    175 WALNUT STREET ULRICH CITY CENTRE, SUITE 7
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    City                 |    LOCKPORT
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    State                |    NY
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    Zip                  |    14094-5368
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    Country              |    US
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    Telephone            |    716-433-1941
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    Fax                  |    716-439-1233
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    194081
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    License Number State |    NY
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