Provider Demographics
NPI:1245200823
Name:CAMPAGNUOLO, JOSEPHINE (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:
Last Name:CAMPAGNUOLO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:91 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07748
Mailing Address - Country:US
Mailing Address - Phone:732-236-9928
Mailing Address - Fax:
Practice Address - Street 1:40 RT 34
Practice Address - Street 2:SUITE E
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08875
Practice Address - Country:US
Practice Address - Phone:732-431-9544
Practice Address - Fax:732-431-9313
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06735300207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
020867PJNMedicare ID - Type Unspecified
NJG81876Medicare UPIN