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Individual

DR. MARK CONDOLUCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
709 HADDONFIELD BERLIN RD, GARDEN STATE INFECTIOUS DISEASES ASSOCIATES, P.A., VOORHEES, NJ 08043-3715
(856) 566-3190
(856) 783-2193
Mailing address
709 HADDONFIELD BERLIN RD, GARDEN STATE INFECTIOUS DISEASES ASSOCIATES, P.A., VOORHEES, NJ 08043-3715
(856) 566-3190
(856) 783-2193

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MB09385700
NJ
207RI0200X
Infectious Disease Physician
Primary
25MB09385700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0476137
NJ
Enumeration date
07/02/2010
Last updated
02/28/2017
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