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General NPI Number Information
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NPI Number | 1245366921
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Entity Type | Individual
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Provider Name | STEVEN J CONDON B.S., M.A., A.T.C
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 NOVACARE WAY PHILADELPHIA EAGLES
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City | PHILADELPHIA
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State | PA
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Zip | 19145-5900
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Country | US
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Telephone | 215-339-5490
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Fax | 215-463-8171
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Provider Business Mailing Address
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Address Line | 213 HARRIS DR
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City | SEWELL
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State | NJ
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Zip | 08080-9459
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Country | US
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Telephone | 856-245-7260
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT003942
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License Number State | PA
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