Provider Demographics
NPI:1821565649
Name:KOROLY, LINDSY (PSYD)
Entity Type:Individual
Prefix:
First Name:LINDSY
Middle Name:
Last Name:KOROLY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 34TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1891
Mailing Address - Country:US
Mailing Address - Phone:914-806-0201
Mailing Address - Fax:
Practice Address - Street 1:341 E 79TH ST APT 302
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1039
Practice Address - Country:US
Practice Address - Phone:914-806-0201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022973103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical