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LINDENWOOD MEDICAL PC
NPI 1811220882
Family Medicine - Adult Medicine in Staten Island, NY

Active since September 09, 2009
11 RALPH PL STE 112, STATEN ISLAND, NY 10304(718) 954-2202 Get Directions Write a Review

NPPES record last updated: January 4, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 4, 2022, Jan 29, 2021 (2 updates tracked since 2021).

About Lindenwood Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LINDENWOOD MEDICAL PC (NPI 1811220882) is a healthcare organization registered as an adult medicine in Staten Island, New York and active in the NPI registry since September 2009. The organization lists Zoya Koroleva, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1811220882
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameLINDENWOOD MEDICAL PC
Location Address11 RALPH PL STE 112Staten Island, NY 10304-4408
Mailing Address11 Ralph Pl Ste 112Staten Island, NY 10304-4408 · (718) 954-2202
Phone(718) 954-2202
Organization SubpartNo
Authorized OfficialZoya KorolevaMedical Director · (718) 954-2202
Enumeration DateSeptember 9, 2009
Last NPPES UpdateJanuary 4, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 3, 2021
✔ NPI 1811220882 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
License✔ Licensed in NY · 251641
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
11 RALPH PL STE 112, Staten Island, NY 10304
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Other Identifiers 1

Medicaid03130027NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZOYA KOROLEVA
Family Medicine
11 RALPH PL STE 112
STATEN ISLAND, NY 10304
Richmond County (718) 954-2202
YANA MAZURENKO FNP
Nurse Practitioner (Family)
11 RALPH PL STE 112
STATEN ISLAND, NY 10304
Richmond County (718) 954-2202
ALISA GALLUCCI FNP
Nurse Practitioner (Family)
11 RALPH PL STE 112
STATEN ISLAND, NY 10304
Richmond County (718) 954-2202
IOSIF KAYDANOV FNP
Nurse Practitioner (Family)
11 RALPH PL STE 112
STATEN ISLAND, NY 10304
Richmond County (718) 954-2202
ADULT GERIATRIC HEALTH NP PC
Nurse Practitioner (Adult Health)
11 RALPH PL STE 112
STATEN ISLAND, NY 10304
Richmond County (347) 377-1979

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lindenwood Medical PC's NPI number?

The NPI number for Lindenwood Medical PC is 1811220882. It was assigned to this organization in the NPPES registry on September 9, 2009.

Where is Lindenwood Medical PC located?

Lindenwood Medical PC is located at 11 Ralph Pl Ste 112, Staten Island, NY 10304. The listed phone number is (718) 954-2202.

What is Lindenwood Medical PC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Lindenwood Medical PC was last updated on January 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.