Healthcare Provider Details

I. General information

NPI: 1750397923
Provider Name (Legal Business Name): LANA KORDUNSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SVETLANA KORDUNSKAYA M.D.

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 BAYSIDE RD
QUINCY MA
02171-1002
US

IV. Provider business mailing address

17 BAYSIDE RD
QUINCY MA
02171-1002
US

V. Phone/Fax

Practice location:
  • Phone: 508-510-2054
  • Fax:
Mailing address:
  • Phone: 508-941-7414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number230620
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: