Provider Demographics
NPI:1508821638
Name:CAMPAGNA, ANGELO JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELO
Middle Name:JOSEPH
Last Name:CAMPAGNA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:175 WALNUT STREET
Mailing Address - Street 2:ULRICH CITY CENTRE, SUITE 7
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-5368
Mailing Address - Country:US
Mailing Address - Phone:716-433-1941
Mailing Address - Fax:716-439-1233
Practice Address - Street 1:ULRICH CITY CENTRE
Practice Address - Street 2:SUITE 7
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-5368
Practice Address - Country:US
Practice Address - Phone:716-433-1941
Practice Address - Fax:716-439-1233
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2011-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY194081207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01454104Medicaid