Provider Demographics
NPI:1083660781
Name:CONDEMI, GIUSEPPE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:GIUSEPPE
Middle Name:
Last Name:CONDEMI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 WHITE BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:RIVER VALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6455
Mailing Address - Country:US
Mailing Address - Phone:201-488-9013
Mailing Address - Fax:
Practice Address - Street 1:718 TEANECK ROAD
Practice Address - Street 2:ST. PATRICIA LYNCH CANCER CERTER.
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4245
Practice Address - Country:US
Practice Address - Phone:201-227-6008
Practice Address - Fax:201-227-6002
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07282200207RH0003X, 174400000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0109941Medicaid
NJ7511400Medicaid
NJ082248VT2Medicare PIN
NJ082248CBVMedicare ID - Type Unspecified
I13979Medicare UPIN
NJI13979Medicare UPIN