Provider Demographics
NPI:1194750968
Name:CORIO, FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:CORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:241 NEWTON SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2771
Mailing Address - Country:US
Mailing Address - Phone:717-293-3223
Mailing Address - Fax:717-390-2455
Practice Address - Street 1:89 SPARTA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1777
Practice Address - Country:US
Practice Address - Phone:973-729-0002
Practice Address - Fax:973-726-4456
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA053220002085R0202X
NJMA532202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1952307Medicaid
NJE22068Medicare UPIN
NJ1952307Medicaid