Provider Demographics
NPI:1629105838
Name:CAMPAGNA, BARBARA ANN (MA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:CAMPAGNA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 GAUL RD N
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3135
Mailing Address - Country:US
Mailing Address - Phone:631-751-6133
Mailing Address - Fax:
Practice Address - Street 1:16 GAUL RD N
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3135
Practice Address - Country:US
Practice Address - Phone:631-751-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007559-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist