Provider Demographics
NPI:1801057997
Name:CAMPOS, JOSE S (MD)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:S
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:901 ROUTE 23 SOUTH
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1025
Mailing Address - Country:US
Mailing Address - Phone:862-666-9285
Mailing Address - Fax:862-666-9287
Practice Address - Street 1:901 ROUTE 23 SOUTH
Practice Address - Street 2:2ND FLOOR
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1025
Practice Address - Country:US
Practice Address - Phone:862-666-9285
Practice Address - Fax:862-666-9287
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2019-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA091961002081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ264998Medicare PIN