Individual
MARINA KOSTYUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
890 MOUNTAIN AVE, NEW PROVIDENCE, NJ 07974-1218
(908) 277-8639
(908) 277-8767
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(917) 774-7425
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00805000
NJ
363LA2200X
Adult Health Nurse Practitioner
26NJ00805000
NJ
Other
Enumeration date
03/19/2018
Last updated
02/23/2023
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