Individual provider Active NPI

Elizabeth Campagna

  • Specialist
  • Holbrook, NY
National Provider Identifier
1114354594
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
270064 Issued in NY
Practice address
16 Normandy Dr
Holbrook, NY 11741-5813
Phone
(631) 374-3698
NPI assigned
Oct 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 270064 NY Primary

Addresses

Primary practice location

16 Normandy Dr
Holbrook, NY 11741-5813

Mailing address

16 Normandy Dr
Holbrook, NY 11741-5813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
270064NYMDPediatrics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1114354594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 NORMANDY DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 NORMANDY DR",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117415813",
            "telephone_number": "631-374-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPAGNA",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "270064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.