Contract Details
Brooklyn Nuclear Spect Imaging, PC
Facility name
Forest Hills Nuclear Spect Imaging, PC
Provider ID
P000005473
NPI
1851402523
Tax ID
113108294
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
2802 Crescent St
Astoria, NY 11102
United States
County
Queens
Phone
7187218310 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address