Provider Demographics
NPI:1255586962
Name:CAMPO, CATHERINE ROSE (DO)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ROSE
Last Name:CAMPO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:ROSE
Other - Last Name:PIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:656 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4900
Mailing Address - Country:US
Mailing Address - Phone:732-531-5200
Mailing Address - Fax:732-531-5836
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:SUITE 2
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:732-531-5200
Practice Address - Fax:732-531-5836
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269630208600000X
NJ25MB09447500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery