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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851603120 | NPPES |
| New Jersey | MEDICAID | 0476137 |
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