Contract Details
Zilkha Radiology
Facility name
Zilkha Radiology
Provider ID
P000003765
NPI
1073788188
Tax ID
112698467
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
1161 Montauk Hwy
West Islip, NY 11795
United States
County
Suffolk
Phone
6312774500 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Diagnostic Services
Map
Address