Provider Demographics
NPI:1932291028
Name:CAMPAIGNE, CURTIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:CAMPAIGNE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 W 86TH ST
Mailing Address - Street 2:APT. 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4002
Mailing Address - Country:US
Mailing Address - Phone:917-843-5503
Mailing Address - Fax:
Practice Address - Street 1:156 W 86TH ST
Practice Address - Street 2:APT. 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4002
Practice Address - Country:US
Practice Address - Phone:917-843-5503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP52863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical