Contract Details
Marine Park Radiology, PC
Facility name
Brooklyn Medical Imaging
Provider ID
P000006255
Tax ID
113214659
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
450 Ave P
Brooklyn, NY 11223
United States
County
Kings
Phone
7183756000 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address