Organization
LINDENWOOD HEALTH MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TATYANA KATSMAN D.O. (PRESIDENT)
(862) 208-9959
Entity
Organization
Contact information
Practice address
3974 AMBOY RD, SUITE 302, STATEN ISLAND, NY 10308
(718) 967-1071
(718) 966-0359
Mailing address
3974 AMBOY RD, SUITE 302, STATEN ISLAND, NY 10308
(718) 967-1071
(718) 966-0359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05146507
—
NY
Enumeration date
02/22/2017
Last updated
06/28/2019
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