Provider Demographics
NPI:1306481833
Name:CAMPANELLA, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CAMPANELLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SANDOR CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4028
Mailing Address - Country:US
Mailing Address - Phone:201-669-1346
Mailing Address - Fax:
Practice Address - Street 1:312 WARREN AVE STE 2
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1563
Practice Address - Country:US
Practice Address - Phone:845-304-1205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty