Provider Demographics
NPI:1184992372
Name:CAMPOPIANO, KEVIN (RN)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:CAMPOPIANO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-2603
Mailing Address - Country:US
Mailing Address - Phone:518-222-6955
Mailing Address - Fax:518-615-0505
Practice Address - Street 1:87 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-2613
Practice Address - Country:US
Practice Address - Phone:518-449-1142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002869171100000X
NY765675163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist