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Individual

MARJORIE MARIE CONDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
106 PROSPECT ST, RIDGEWOOD, NJ 07450
(201) 689-1933
(201) 689-1935
Mailing address
106 PROSPECT ST, RIDGEWOOD, NJ 07450
(201) 689-1933
(201) 689-1935

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MB54119
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7177003
NJ
Enumeration date
07/03/2006
Last updated
01/13/2011
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