Organization
ICONIC MEDICAL AND WELLNESS CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA KOROGODSKY PA-C (PHYSICIAN ASSISTANT)
(908) 403-1160
Entity
Organization
Contact information
Practice address
5 COLD HILL RD S STE 26J, MENDHAM, NJ 07945-3208
(973) 531-6377
Mailing address
5 COLD HILL RD S STE 26J, MENDHAM, NJ 07945-3208
(973) 531-6377
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
01/19/2021
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