Organization
DOMINICK CONDO, MD PA
Active
Other names
Simone & Condo, PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINICK CONDO MD (MEDICAL DIRECTOR)
(201) 436-2800
Entity
Organization
Contact information
Practice address
622 BROADWAY, BAYONNE, NJ 07002-3821
(201) 436-2800
(201) 436-9840
Mailing address
PO BOX 51, BAYONNE, NJ 07002-0051
(201) 436-2800
(201) 436-9840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA041384
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1179004
—
NJ
01
—
1K6533
HEALTHNET
NJ
01
—
4121298
CIGNA
NJ
01
—
70970
AETNA
NJ
01
—
8177
GHI
NJ
01
—
HP095
OXFORD
NJ
Enumeration date
09/22/2006
Last updated
09/09/2010
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