| Dominick Condo, Md Pa | |
|
622 Broadway Bayonne NJ 07002-3821 | |
| (201) 436-2800 | |
| (201) 436-9840 |
| Full Name | Dominick Condo, Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 622 Broadway, Bayonne, New Jersey |
| Authorized Official Name and Position | Dominick Condo (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2014362800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominick Condo, Md Pa Po Box 51 Bayonne NJ 07002-0051 Ph: (201) 436-2800 | Dominick Condo, Md Pa 622 Broadway Bayonne NJ 07002-3821 Ph: (201) 436-2800 |
| NPI Number | 1588764500 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 5890689871 |
|---|---|
| Medicare Enrollment ID | O20040211000071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588764500 | NPI | - | NPPES |
| 1179004 | Medicaid | NJ | |
| 1K6533 | Other | NJ | HEALTHNET |
| 4121298 | Other | NJ | CIGNA |
| 70970 | Other | NJ | AETNA |
| 8177 | Other | NJ | GHI |
| HP095 | Other | NJ | OXFORD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA041384 (New Jersey) | Primary |
| Provider Name | Dominick Condo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114019692 PECOS PAC ID: 8224922208 Enrollment ID: I20060112000107 |
| Provider Name | Hammad S Choudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346285079 PECOS PAC ID: 8123023538 Enrollment ID: I20060918000515 |
| Provider Name | Angela D Condo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780079020 PECOS PAC ID: 4688928492 Enrollment ID: I20190306001183 |
| Provider Name | Samreen Tariq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164803714 PECOS PAC ID: 9830439967 Enrollment ID: I20190327001344 |
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