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NPI Code Detail

MEDICARE: DR. GEORGE KONDYLIS MD

MEDICARE: DR. GEORGE KONDYLIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician154305MA

General Provider Information

NPI Number : 1720075534
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE KONDYLIS MD
Provider Business Mailing Address
First Line : 1 GENERAL STREET
Second Line :
City : LAWRENCE
State : MA
Zip : 01842
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 GENERAL ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01841-2961
Country : US
Telephone Number : 978-683-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 07/08/2007

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Directions to “ DR. GEORGE KONDYLIS MD” Practice Location

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