IndividualActive
Kimberly Zedalis
NPI 1124276282 · Radiology Practitioner Assistant · Lake Grove, NY
Provider details
- NPI number
- 1124276282
- Entity type
- Individual
- Primary specialty
- Radiology Practitioner AssistantTechnologists, Technicians & Other Technical Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 956080 (NY)
Practice location
2780 Middle Country Rd
Ste 210
Lake Grove, NY 11755-2124
Phone: (631) 588-4500
Fax: (631) 588-4595
Mailing address
2780 Middle Country Rd
Lake Grove, NY 11755-2124
Registry dates
- Enumerated
- 2008-09-03
- Last updated
- 2008-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.