Organization
LINDENWOOD MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZOYA KOROLEVA (MEDICAL DIRECTOR)
(718) 954-2202
Entity
Organization
Contact information
Practice address
11 RALPH PL STE 112, STATEN ISLAND, NY 10304-4408
(718) 954-2202
Mailing address
11 RALPH PL STE 112, STATEN ISLAND, NY 10304-4408
(718) 954-2202
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
251641
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03130027
—
NY
Enumeration date
09/09/2009
Last updated
01/04/2022
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