Provider Demographics
NPI:1043565351
Name:CAMPOLI, JEFFREY QUIRINO
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:QUIRINO
Last Name:CAMPOLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:484 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-6006
Mailing Address - Country:US
Mailing Address - Phone:802-734-0745
Mailing Address - Fax:
Practice Address - Street 1:484 STRATFORD RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-6006
Practice Address - Country:US
Practice Address - Phone:802-734-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist