Jennifer Dawn Condlin, RN is a
Nurse Practitioner - Family based in Portjefferson, New York. Jennifer Dawn Condlin is licensed to practice in New York (license number 346007) and her current practice location is
75 North Country Road, Portjefferson, New York. She can be reached at her office (for appointments etc.) via phone at
(631) 473-1320.
NPI number for Jennifer Dawn Condlin is 1720360340 and her current mailing address is 75 North Country Road, Portjefferson, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1720360340.
Provider's Profile
| Full Name | Jennifer Dawn Condlin |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 75 North Country Road, Portjefferson, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1720360340
- Provider Enumeration Date: 09/10/2011
- Last Update Date: 05/05/2021
Medical Identifiers
Medical identifiers for Jennifer Dawn Condlin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720360340 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 636754-1 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F346007-01 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 346007 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jennifer Dawn Condlin is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jennifer Dawn Condlin, RN
75 North Country Road,
Portjefferson, NY 11777
Ph: (631) 473-1320 | Jennifer Dawn Condlin, RN
75 North Country Road,
Portjefferson, NY 11777
Ph: (631) 473-1320 |
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