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Organization
IDEAL IDTF SERVICES OF NEW YORK, INC.
Active
Organization
IDEAL IDTF SERVICES OF NEW YORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE PINA (PRESIDENT)
(646) 533-7790
Entity
Organization
Contact information
Practice address
4394 BROADWAY, NEW YORK, NY 10040-4002
(212) 795-1221
Mailing address
4394 BROADWAY, NEW YORK, NY 10040-4002
(212) 795-1221
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
225100000X
Physical Therapist
—
—
246Q00000X
Pathology Specialist/Technologist
—
—
246W00000X
Cardiology Technician
—
—
246Z00000X
Other Specialist/Technologist
—
—
247100000X
Radiologic Technologist
—
—
2471B0102X
Bone Densitometry Radiologic Technologist
—
—
247200000X
Other Technician
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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