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NPI 1770904138

OrganizationActive

Dominick Condo MD PA

NPI 1770904138 · Non-Pharmacy Dispensing Site · Bayonne, NJ

Provider details

NPI number: 1770904138
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc
Authorized official: Kenny Heine, Vp of Operations
License: 25MA08097300 (NJ)

Practice location

622 Broadway

Bayonne, NJ 07002-3821

Phone: (201) 436-2800

More NJ providers

Mailing address

9276 Scranton Rd

San Diego, CA 92121-7701

Registry dates

Enumerated: 2014-01-02
Last updated: 2015-12-10

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Dominick Condo MD PA — NPI 1770904138, Bayonne, NJ | NPI Central