Individual
MARIA KOROGODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
65 BERGEN ST, NEWARK, NJ 07107-3001
(973) 972-5686
Mailing address
27 SOFTWOOD WAY, WARREN, NJ 07059-6791
(973) 972-5686
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00067500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00067500
GASTROENTEROLOGY
NJ
Enumeration date
09/23/2008
Last updated
08/07/2023
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