Provider Demographics
NPI:1447223698
Name:ACAMPORA, VINCENT J (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:ACAMPORA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CIRCLE LANE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003
Mailing Address - Country:US
Mailing Address - Phone:856-424-4525
Mailing Address - Fax:856-424-9545
Practice Address - Street 1:1930 E MARLTON PIKE
Practice Address - Street 2:#O-77
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003
Practice Address - Country:US
Practice Address - Phone:856-424-4525
Practice Address - Fax:856-424-9545
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03353300207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2367106Medicaid
NJ448543Medicare ID - Type Unspecified
NJ078851Medicare PIN
NJ2367106Medicaid