Contract Details
Brooklyn Nuclear Spect Imaging, PC
Facility name
Quantum Cardiovascular Services
Provider ID
P000006220
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
6414 Myrtle Ave
Ridgewood, NY 11385
United States
County
Queens
Phone
8009926827 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address