Campodonico, Jeffrey

Campodonico, Jeffrey is an individual health care provider with primary practice located at 120 Sister Pierre Dr Suite 501, Towson MD 21204-7516. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Campodonico, Jeffrey can be contacted via phone (410) 337-6801.

Contact Information

Primary practice address
120 Sister Pierre Dr Suite 501 Towson MD 21204-7516
Phone: (410) 337-6801
Fax: (410) 337-8686
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 3071 Maryland

Profile Details

NPI number 1407908395
LBN Legal business name Campodonico, Jeffrey
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Jan 24th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407908395 NPPES
Maryland Other 706M MEDICARE GROUP ID NO.
Maryland Other KEJ2JE MEDICARE GROUP ID NO.
Maryland MEDICAID 403513500 MEDICARE GROUP ID NO.

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