Provider Demographics
NPI:1902514508
Name:CORREDO-SARABIA, INGRID ANTONIETA (MD)
Entity type:Individual
Prefix:DR
First Name:INGRID
Middle Name:ANTONIETA
Last Name:CORREDO-SARABIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 TONNELLE AVE # 3203
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2985
Mailing Address - Country:US
Mailing Address - Phone:917-891-5316
Mailing Address - Fax:201-758-2740
Practice Address - Street 1:7600 RIVER RD,
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047
Practice Address - Country:US
Practice Address - Phone:917-891-5316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other