Healthcare Provider Details

I. General information

NPI: 1205078193
Provider Name (Legal Business Name): ZORAN KOROSKOSKI PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CAMBRIDGE DR
NORTH CALDWELL NJ
07006-4227
US

IV. Provider business mailing address

26 CAMBRIDGE DR
NORTH CALDWELL NJ
07006-4227
US

V. Phone/Fax

Practice location:
  • Phone: 973-896-3894
  • Fax:
Mailing address:
  • Phone: 973-896-3894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA01304000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: