Provider Demographics
NPI:1982681896
Name:CAMPAGNA, FRANCIS N JR
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:N
Last Name:CAMPAGNA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 DEPTFORD CENTER RD
Mailing Address - Street 2:2E5B DEPTFORD MALL
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096
Mailing Address - Country:US
Mailing Address - Phone:856-384-0388
Mailing Address - Fax:
Practice Address - Street 1:1750 DEPTFORD CENTER RD
Practice Address - Street 2:2E5B DEPTFORD MALL
Practice Address - City:DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08096-5222
Practice Address - Country:US
Practice Address - Phone:856-384-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00453700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U46130Medicare UPIN
766890CQMMedicare ID - Type Unspecified