Basic Information
| Provider Information | |||||||||
| NPI: | 1609968676 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CAMPO | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 DIAMOND HILL RD | ||||||||
| Address2: | |||||||||
| City: | BERKELEY HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079222104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082734300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 277 FOREST AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014898900 | ||||||||
| FaxNumber: | 2014890877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 03/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 25MA06409300 | NJ | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 10203 | 01 | NJ | MEDICHOICE | OTHER | 971867 | 01 | NJ | FIRST HEALTH | OTHER | 1000752 | 01 | NJ | GHI | OTHER | 2984400 012 | 01 | NJ | CIGNA | OTHER | 340016986 | 01 | NJ | RAIL ROAD | OTHER | 366167 | 01 | NJ | PHCS | OTHER | 1434931 | 01 | NJ | UNITED HEALTHCARE | OTHER | P414450 | 01 | NJ | OXFORD | OTHER | 1K 2196 | 01 | NJ | HEALTHNET | OTHER | 1K 2196 | 01 | NJ | PHS | OTHER | 2158585 | 01 | NJ | AETNA | OTHER | 31764 | 01 | NJ | MASTERCARE | OTHER | 58121705 | 01 | NJ | MULTIPLAN | OTHER | 22742 | 01 | NJ | UNIVERSITY | OTHER | 82L75 1 | 01 | NJ | EMPIRE | OTHER | 7059205 | 05 | NJ | MEDICAID | 82L75 1 | 01 | NJ | WELLCHOICE | OTHER |