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General NPI Number Information
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NPI Number | 1447640362
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Entity Type | Individual
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Provider Name | DENNIS KORDIE
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Gender | Male
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Dates
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Enumeration Date | 01/30/2015
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 134 EVERGREEN PL STE 705
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City | EAST ORANGE
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State | NJ
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Zip | 07018-2012
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Country | US
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Telephone | 973-641-8836
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Fax | 973-695-3795
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Provider Business Mailing Address
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Address Line | 134 EVERGREEN PL STE 705
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City | EAST ORANGE
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State | NJ
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Zip | 07018-2012
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Country | US
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Telephone | 973-641-8836
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Fax | 973-695-3795
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00541900
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License Number State | NJ
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