MEDICARE: PRATHIBHA KOREKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA01534600	NJ

General Provider Information

NPI Number	:	1124385901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRATHIBHA KOREKA

Provider Business Mailing Address
First Line	:	2245 US HIGHWAY 130 STE 105
Second Line	:
City	:	DAYTON
State	:	NJ
Zip	:	08810-2420
Country	:	US
Telephone Number	:	732-609-7155
Fax Number	:	609-228-6173

Provider Business Practice Location Address
First Line	:	2245 US HIGHWAY 130 STE 105
Second Line	:
City	:	DAYTON
State	:	NJ
Zip	:	08810-2420
Country	:	US
Telephone Number	:	732-609-7155
Fax Number	:	609-228-6173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2012
Last Update Date	:	02/06/2026

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Directions to “ PRATHIBHA KOREKA ” Practice Location

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