Individual ProviderMichael CampbellNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address451 Clarkson Ave, Brooklyn, NY 11203-2054(347) 633-7353PECOS EnrollmentBased on the most recent information from CMS, provider Michael Campbell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1225622582Provider TypeIndividualFull NameCampbell, MichaelTitleMr.GenderMaleSole ProprietorNoEnumeration Date2/25/2021Last Updated2/25/2021Contact InformationPractice LocationPractice Address451 Clarkson Ave, Brooklyn, NY 11203-2054Phone(347) 633-7353FaxUnlisted FaxMailing LocationMailing Address10105 Avenue J, Brooklyn, NY 11236-4019PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense347345New York