Provider Demographics
NPI:1689351546
Name:KOROMA, JOSEPH MOJOKO (CRNP)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MOJOKO
Last Name:KOROMA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:155 E TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-1031
Mailing Address - Country:US
Mailing Address - Phone:484-620-0710
Mailing Address - Fax:
Practice Address - Street 1:5600 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19139-3232
Practice Address - Country:US
Practice Address - Phone:215-747-4511
Practice Address - Fax:888-501-3503
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PASP027535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily