MEDICARE: BRITTANI ELISSE CAMPELO DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	25MB12867300	NJ
2	208000000X	Pediatrics Physician	323924	NY

General Provider Information

NPI Number	:	1023646841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANI ELISSE CAMPELO DO

Provider Business Mailing Address
First Line	:	4802 10TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2916
Country	:	US
Telephone Number	:	718-283-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4802 10TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2916
Country	:	US
Telephone Number	:	718-283-6000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2020
Last Update Date	:	02/05/2026

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