Condoluci, Mark

Condoluci, Mark is an sole proprietor health care provider with primary practice located at 709 Haddonfield Berlin Rd Garden State Infectious Diseases Associates, P.A., Voorhees NJ 08043-3715. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Condoluci, Mark can be contacted via phone (856) 566-3190.

Contact Information

Primary practice address
709 Haddonfield Berlin Rd Garden State Infectious Diseases Associates, P.A. Voorhees NJ 08043-3715
Phone: (856) 566-3190
Fax: (856) 783-2193
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MB09385700 New Jersey
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 25MB09385700 New Jersey

Profile Details

NPI number 1851603120
LBN Legal business name Condoluci, Mark
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2010
Last updated Feb 28th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851603120 NPPES
New Jersey MEDICAID 0476137

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