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General NPI Number Information
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NPI Number | 1083493902
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Entity Type | Organization
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Legal Business Name | CONDON PSYCHIATRY PLLC
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Dates
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Enumeration Date | 09/28/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1110 BOSTON POST RD REAR
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City | GUILFORD
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State | CT
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Zip | 06437-2677
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Country | US
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Telephone | 475-221-3399
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Fax | 475-223-0094
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Provider Business Mailing Address
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Address Line | 1204 MAIN ST STE 528
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City | BRANFORD
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State | CT
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Zip | 06405-3787
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Country | US
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Telephone | 475-221-3399
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RORY VINCENT CONDON
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Credential | APRN
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Telephone | 475-221-3399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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