Doctor Name: | KIMBERLY D. ZEDALIS |
NPI Number: | 1124276282 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 956080 |
Business Practice Address: | 2780 Middle Country Rd Ste 210 Lake Grove, NY - 117552124 |
Business Phone Number: | 6315884500 |
Business Fax Number: | 6315884595 |
Mailing Address: | 2780 Middle Country Rd, Ste 210 LAKE GROVE |
State: | NY |
Postal Code: | 117552124 |
Phone Number: | 6315884500 |
Fax Number: | 6315884595 |
NPI Enumeration Date: | 09/03/2008 |
NPI Last Update Date: | 10/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | 956080 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |