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General NPI Number Information
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NPI Number | 1538485305
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Entity Type | Organization
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Legal Business Name | ANTHONY CAMPO MD PC
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 67 HAMPTON RD UNIT 204
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-4962
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Country | US
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Telephone | 631-259-8000
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Fax | 631-259-8656
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Provider Business Mailing Address
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Address Line | 67 HAMPTON RD UNIT 204
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-4962
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Country | US
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Telephone | 631-259-8000
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Fax | 631-259-8656
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY CAMPO
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Credential | MD
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Telephone | 631-259-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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