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JEFFREY CAMPODONICO PH.D.

Clinical Neuropsychologist

Towson, Maryland

Provider NPI: 1407908395

Provider Information:
 JEFFREY  CAMPODONICO PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
120 SISTER PIERRE DR SUITE 501 TOWSON, MD 21204 US
Tel: 410-337-6801  Fax: 410-337-8686

Business Mailing Address:
120 SISTER PIERRE DR SUITE 501 TOWSON, MD 21204 US
Tel: 410-598-4966  Fax: 410-337-8686

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MD3071

Other Provider Identifiers:

IssuerNumberStateType
MEDICARE GROUP ID NO.706MMD01
403513500MD05
BCBS PREFERRED PROVIDERKEJ2JEMD01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS MD - Page 1



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