Healthcare Provider Details

I. General information

NPI: 1639321870
Provider Name (Legal Business Name): IDF MEDICAL DIAGNOSTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 GRAND CONCOURSE LOWER LEVEL
BRONX NY
10453-4994
US

IV. Provider business mailing address

1963 GRAND CONCOURSE LOWER LEVEL
BRONX NY
10453-4994
US

V. Phone/Fax

Practice location:
  • Phone: 718-731-2500
  • Fax:
Mailing address:
  • Phone: 718-731-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: BHUPINDER SINGH SAWHNEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-731-2500