Provider Demographics
NPI:1538151147
Name:HILAL-CAMPO, DIANE MARIE (MD)
Entity type:Individual
Prefix:MISS
First Name:DIANE
Middle Name:MARIE
Last Name:HILAL-CAMPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 YAWPO AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2717
Mailing Address - Country:US
Mailing Address - Phone:201-337-9300
Mailing Address - Fax:201-405-0558
Practice Address - Street 1:43 YAWPO AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2714
Practice Address - Country:US
Practice Address - Phone:201-337-9300
Practice Address - Fax:201-405-0558
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06404700174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7799705Medicaid
NJ4287460001Medicare NSC
NJHI873511Medicare PIN
NJG28831Medicare UPIN
NJHI873511Medicare ID - Type Unspecified
NJ7799705Medicaid