Provider Demographics
NPI:1801515143
Name:DR. DIANE HILAL-CAMPO
Entity type:Organization
Organization Name:DR. DIANE HILAL-CAMPO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-337-9300
Mailing Address - Street 1:43 YAWPO AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2717
Mailing Address - Country:US
Mailing Address - Phone:201-337-9300
Mailing Address - Fax:
Practice Address - Street 1:43 YAWPO AVE STE 1
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2717
Practice Address - Country:US
Practice Address - Phone:201-337-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1699730937OtherSTATE OF NEW JERSEY
NJ148445360OtherSTATE OF NEW JERSEY