Provider Demographics
NPI:1144394560
Name:WILLIAM J. CAMPAGNOLO
Entity Type:Organization
Organization Name:WILLIAM J. CAMPAGNOLO
Other - Org Name:BARNEGAT FAMILY CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMPAGNOLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:609-698-5550
Mailing Address - Street 1:890 W BAY AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2150
Mailing Address - Country:US
Mailing Address - Phone:609-698-5550
Mailing Address - Fax:609-698-3031
Practice Address - Street 1:890 W BAY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2150
Practice Address - Country:US
Practice Address - Phone:609-698-5550
Practice Address - Fax:609-698-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00291800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3363201Medicaid
NJ3363201Medicaid
NJ536609Medicare PIN
NJ100443Medicare PIN