Contract Details
Facility name
Brooklyn Nuclear Spect Imaging, PC
Provider ID
P000004730
NPI
1518912096
Tax ID
113020599
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
1435 86th St
Brooklyn, NY 11228
United States
County
Kings
Phone
7188370010 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address