Provider Demographics
NPI:1982923025
Name:UNIVERSAL IDTF SERVICES INC
Entity Type:Organization
Organization Name:UNIVERSAL IDTF SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-6300
Mailing Address - Street 1:251 E 5TH ST
Mailing Address - Street 2:SUITE C104
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2403
Mailing Address - Country:US
Mailing Address - Phone:718-338-6300
Mailing Address - Fax:347-710-1969
Practice Address - Street 1:251 E 5TH ST
Practice Address - Street 2:SUITE C104
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2403
Practice Address - Country:US
Practice Address - Phone:718-338-6300
Practice Address - Fax:347-710-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty