Provider Demographics
NPI:1861566457
Name:CAMPIONE, MICHELE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:CAMPIONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10276-1032
Mailing Address - Country:US
Mailing Address - Phone:917-453-4144
Mailing Address - Fax:212-600-0308
Practice Address - Street 1:242 E 72ND ST
Practice Address - Street 2:SUITE 1 -A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4574
Practice Address - Country:US
Practice Address - Phone:917-453-4144
Practice Address - Fax:212-600-0308
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2013-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1967602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01920167Medicaid
NYH43452Medicare UPIN
NY012BZ1Medicare ID - Type Unspecified