Provider Demographics
NPI:1013664986
Name:CAMPORINI, VICTORIA PIERCE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:PIERCE
Last Name:CAMPORINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HILLTOP CIR
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1404
Mailing Address - Country:US
Mailing Address - Phone:727-512-2576
Mailing Address - Fax:
Practice Address - Street 1:4 INDUSTRIAL WAY W STE 101
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-4239
Practice Address - Country:US
Practice Address - Phone:732-945-6555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01281800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner