DOMINICK CONDO MD PA
NPI 1770904138
Non-Pharmacy Dispensing Site in Bayonne, NJ

Active since January 02, 2014
622 BROADWAY, BAYONNE, NJ 07002(201) 436-2800 Get Directions Write a Review

NPPES record last updated: December 10, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dominick Condo Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINICK CONDO MD PA (NPI 1770904138) is a healthcare organization registered as a non-pharmacy dispensing site in Bayonne, New Jersey and active in the NPI registry since January 2014. The organization lists Kenny Heine, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1770904138
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameDOMINICK CONDO MD PA
Location Address622 BROADWAYBayonne, NJ 07002-3821
Mailing Address9276 Scranton Rd, Suite 100San Diego, CA 92121-7701
Organization SubpartYesParent: Medvantx, Inc
Authorized OfficialKenny HeineVp Of Operations · (858) 964-1506
Enumeration DateJanuary 2, 2014
Last NPPES UpdateDecember 10, 2015
NPI 1770904138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
License Licensed in NJ · 25MA08097300
Definition

A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

622 BROADWAY, Bayonne, NJ 07002

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
622 BROADWAY
BAYONNE, NJ 07002
Internal Medicine
622 BROADWAY
BAYONNE, NJ 07002
Family Medicine
622 BROADWAY
BAYONNE, NJ 07002
Internal Medicine (Geriatric Medicine)
622 BROADWAY
BAYONNE, NJ 07002

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominick Condo MD PA's NPI number?

The NPI number for Dominick Condo MD PA is 1770904138. It was assigned to this organization in the NPPES registry on January 2, 2014.

Where is Dominick Condo MD PA located?

Dominick Condo MD PA is located at 622 Broadway, Bayonne, NJ 07002. The listed phone number is (201) 436-2800.

What is Dominick Condo MD PA's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

When was this NPI record last updated?

The NPPES record for Dominick Condo MD PA was last updated on December 10, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.