Individual
ARIADNE P COUSOULAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
637 ROUTE 23 STE 300, POMPTON PLAINS, NJ 07444-1419
(862) 666-9210
Mailing address
230 WEST PARKWAY, UNIT #10, POMPTON PLAINS, NJ 07440
(973) 835-0800
(973) 616-2766
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00132000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0430595
—
NJ
Enumeration date
06/16/2008
Last updated
01/29/2024
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