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General NPI Number Information
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NPI Number | 1811552474
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Entity Type | Individual
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Provider Name | BYRON CAMPISI HIS
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Gender | Male
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 1996 ROUTE 9W
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5423
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Country | US
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Telephone | 845-485-0168
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Fax | 845-336-0261
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Provider Business Mailing Address
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Address Line | 1996 ROUTE 9W
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5423
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Country | US
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Telephone | 845-485-0168
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Fax | 845-336-0261
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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 | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 14000001611
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 14000001611
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License Number State | NY
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