Provider Demographics
NPI:1063583250
Name:CAMPIONE, THOMAS (APN-C, DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CAMPIONE
Suffix:
Gender:M
Credentials:APN-C, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 COUNTY RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CRESSKILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07626-2203
Mailing Address - Country:US
Mailing Address - Phone:201-569-0500
Mailing Address - Fax:201-569-5561
Practice Address - Street 1:135 COUNTY RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-2203
Practice Address - Country:US
Practice Address - Phone:201-569-0500
Practice Address - Fax:201-569-5561
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00524400111NN0400X
NJ26NJ00816800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ021348Medicare ID - Type Unspecified
NJU72715Medicare UPIN