Contract Details
Bab Radiology
Facility name
Bab Radiology
Provider ID
P000004067
NPI
1235116179
Tax ID
113000301
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
763 Larkfield Rd Suite 103
Commack, NY 11725
United States
County
Suffolk
Phone
6314895000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address