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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