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General NPI Number Information
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NPI Number | 1336361385
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Entity Type | Individual
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Provider Name | ALEX VIDAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 1916 UNION BLVD. DEPARTMENT OF CARDIOLOGY
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City | BAYSHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-666-2290
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Fax |
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Provider Business Mailing Address
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Address Line | 1916 UNION BLVD. DEPARTMENT OF CARDIOLOGY
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City | BAYSHORE
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State | NY
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Zip | 11706
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Country | US
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Telephone | 631-666-2290
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Fax | 631-647-8068
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0002X
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Taxonomy Name | Adult Congenital Heart Disease Physician
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License Number | 252831
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 252831
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RH0005X
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Taxonomy Name | Hypertension Specialist Physician
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License Number | 252831
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207UN0902X
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Taxonomy Name | Nuclear Imaging & Therapy Physician
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License Number | 252831
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 252831
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License Number State | NY
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