Basic Information
| Provider Information | |||||||||
| NPI: | 1902996796 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAMPELLONE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422445 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 COOPER PLZ | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081031438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563422445 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 04/22/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MA63918 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | MD058062L | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 010003875 | 01 | NJ | AMERICHOICE | OTHER | 0966963000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 6962106 | 05 | NJ | MEDICAID | 0578869 | 01 | NJ | AETNA | OTHER | 1563590 | 01 | NJ | CIGNA | OTHER | 1051786 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 15188 | 01 | NJ | UNIVERSITY HEALTH PLAN | OTHER | 3K6119 | 01 | NJ | HEALTHNET, INC | OTHER | 860250 | 01 | NJ | AMERIHEALTH PPO/PABS | OTHER | 1448372 | 01 | NJ | UNITED HEALTHCARE | OTHER | P414460 | 01 | NJ | OXFORD | OTHER |