Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberly D. Zedalis

Individual provider Radiologic Technologist · NPI 1124276282

Kimberly D. Zedalis is a Radiologic Technologist in Lake Grove, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
Specialties on file
3

Practice location Address checks out

2780 Middle Country Rd Ste 210
Lake Grove, NY 11755-2124
Phone: (631) 588-4500
Fax: (631) 588-4595
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Radiology Practitioner Assistant (primary) Taxonomy 243U00000X · Licence 000142 (NY)
Radiologic Technologist Taxonomy 247100000X · Licence 956080 (NY)
Mammography Radiologic Technologist Taxonomy 2471M2300X · Licence 956080 (NY)

Record details

NPI number1124276282
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 3, 2008
Last updated in NPPESOctober 1, 2008
Mailing address2780 Middle Country Rd, Ste 210, Lake Grove, NY 11755-2124