Provider Demographics
NPI:1245366921
Name:CONDON, STEVEN J (BS, MA, ATC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:J
Last Name:CONDON
Suffix:
Gender:M
Credentials:BS, MA, ATC
Other - Prefix:
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Mailing Address - Street 1:213 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9459
Mailing Address - Country:US
Mailing Address - Phone:856-245-7260
Mailing Address - Fax:
Practice Address - Street 1:1 NOVACARE WAY
Practice Address - Street 2:PHILADELPHIA EAGLES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-5900
Practice Address - Country:US
Practice Address - Phone:215-339-5490
Practice Address - Fax:215-463-8171
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PART0039422255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer