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Individual

THOMAS J CONDON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
135 GOLD STAR BLVD, WORCESTER, MA 01606
(508) 856-9599
(508) 854-4997
Mailing address
630 PLANTATION ST, WOT 12TH FLOOR ATTN PHYSICIAN SERVICES, WORCESTER, MA 01605
(508) 368-5529
(508) 368-5530

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
30422
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0800301
EVERCARE
01
26726
HEALTHY START
01
3099725
WELFARE
05
3099725
MA
01
35481129
CIGNA HEALTH PLAN
01
5245190
AETNA US HEALTHCARE
01
784011
MVP HEALTH CARE
01
917608
FIRST HEALTH
01
9900030
FALLON COMMUNITY HEALTH
01
AA3296
HARVARD PILGRIM HEALTHCAR
01
N01518
BLUE SHIELD INDEMNITY
Enumeration date
05/03/2006
Last updated
07/08/2007
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