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LINDENWOOD MEDICAL PC NPI 1811220882


NPI Information

NPI: 1811220882
Provider Name: LINDENWOOD MEDICAL PC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
11 RALPH PL STE 112
STATEN ISLAND, NY
ZIP 10304
Phone: (718) 954-2202
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LINDENWOOD MEDICAL PC is an adult medicine family medicine in Staten Island, NY. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. LINDENWOOD MEDICAL PC NPI is 1811220882. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11 RALPH PL STE 112
STATEN ISLAND, NY
ZIP 10304-408
Phone: (718) 954-2202

The provider's authorized official is Zoya Koroleva .
The authorized official title is Medical Director and has the following contact phone number (718) 954-2202.

The enumeration date for this NPI number is 9/9/2009 and was last updated on 1/4/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207QA0505XFamily MedicineAdult Medicine251641NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103130027MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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