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General NPI Number Information
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NPI Number | 1518174267
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Entity Type | Organization
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Legal Business Name | IDMED CARE PLLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 142 JORALEMON ST STE 9B
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City | BROOKLYN
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State | NY
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Zip | 11201
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Country | US
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Telephone | 718-858-1732
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Fax | 718-596-3332
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Provider Business Mailing Address
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Address Line | PO BOX 23424
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City | BROOKLYN
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State | NY
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Zip | 11202
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Country | US
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Telephone | 718-858-1732
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Fax | 718-596-3332
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Authorized Official
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Title or Position | OWNER SOLE MEMBER
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Name | OFELIA V CALUBIRAN
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Credential | MD
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Telephone | 718-858-1732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 175306
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 175306
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License Number State | NY
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