| Edward Condon Medical PC | |
|
6080 Jericho Tpke Suite 314 Commack NY 11725-2850 | |
| (631) 462-2200 | |
| (866) 852-5985 |
| Full Name | Edward Condon Medical PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 6080 Jericho Tpke, Commack, New York |
| Authorized Official Name and Position | Edward Michael Condon (PRESIDENT) |
| Authorized Official Contact | 6314622200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Condon Medical PC 6080 Jericho Tpke Suite 314 Commack NY 11725-2850 Ph: (631) 462-2200 | Edward Condon Medical PC 6080 Jericho Tpke Suite 314 Commack NY 11725-2850 Ph: (631) 462-2200 |
| NPI Number | 1811174519 |
|---|---|
| Provider Enumeration Date | 01/24/2008 |
| Last Update Date | 07/12/2013 |
| Medicare PECOS PAC ID | 6608954433 |
|---|---|
| Medicare Enrollment ID | O20080506000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811174519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 127245 (New York) | Primary |
| Provider Name | Edward M Condon |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1225058969 PECOS PAC ID: 4284601998 Enrollment ID: I20040913000959 |
| Provider Name | Maria E Pena |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1487815361 PECOS PAC ID: 2668620907 Enrollment ID: I20120912000211 |
| Provider Name | Michelle R. Lorge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659781524 PECOS PAC ID: 8123337573 Enrollment ID: I20151026001178 |
| Provider Name | Monica a Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831476647 PECOS PAC ID: 7810207651 Enrollment ID: I20151109000118 |
| Provider Name | Virginia Maeve Mchale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649653270 PECOS PAC ID: 7012215205 Enrollment ID: I20160421001526 |
| Provider Name | Olga Makrak-sturniolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437603289 PECOS PAC ID: 1759679764 Enrollment ID: I20161006001614 |
| Provider Name | Janine M D'amico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851840540 PECOS PAC ID: 3173895224 Enrollment ID: I20170824000129 |
| Provider Name | Lani Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942727797 PECOS PAC ID: 3577820968 Enrollment ID: I20171120000649 |
| Provider Name | Hye Min Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447839857 PECOS PAC ID: 4183088370 Enrollment ID: I20230906002453 |
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