Provider Demographics
NPI:1922088350
Name:CAMPAGNOLO, WILLIAM JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:CAMPAGNOLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC00291800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3363201Medicaid
NJ536609Medicare PIN
NJT45730Medicare UPIN