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
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Practice location Address checks out

1015 Tyrone Rd # 410-C
Tyrone, GA 30290-2407
Phone: (470) 818-2264
Fax: (866) 984-3729
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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
Mailing address5530 Old National Hwy Bldg 5530-B2, College Park, GA 30349-6234