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General NPI Number Information
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NPI Number | 1689705618
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Entity Type | Individual
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Provider Name | DENNIS JAMES KONDASH D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 11/25/2016
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Provider Practice Location Address
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Address Line | 211 N 12TH ST
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City | LEHIGHTON
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State | PA
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Zip | 18235-1138
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Country | US
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Telephone | 610-377-7174
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Fax | 610-377-4785
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Provider Business Mailing Address
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Address Line | 211 N 12TH ST
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City | LEHIGHTON
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State | PA
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Zip | 18235-1138
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Country | US
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Telephone | 610-377-7174
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Fax | 610-377-4785
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OS004813L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | C2-0007569
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | OS004813L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | C2-0007569
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | C2-0007569
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License Number State | DE
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