Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Idesta Ralph

Individual provider Phlebotomy Technician · NPI 1205235371

Idesta Ralph is a Phlebotomy Technician in Tyrone, Georgia. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2014
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1015 Tyrone Rd # 410-C
Tyrone, GA 30290-2407
Phone: (470) 818-2264
Fax: (866) 984-3729
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Phlebotomy Technician (primary) Taxonomy 246RP1900X · Licence 56083 (NY)

Record details

NPI number1205235371
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 14, 2014
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026