| Justin Zack, MD | |
|
1333 Roanoke Ave, Riverhead, NY 11901 | |
| (631) 727-2755 | |
| (631) 208-9521 |
| Full Name | Justin Zack |
|---|---|
| Gender | Male |
| Speciality | Radiology - Vascular & Interventional Radiology |
| Location | 1333 Roanoke Ave, Riverhead, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407964695 | NPI | - | NPPES |
| 02206999 | Medicaid | NY | |
| CF3402 | Other | NY | RR MEDICARE |
| W11401 | Other | NY | BC/BS |
| W22111 | Other | NY | MEDICARE GROUP SHR |
| WEU091 | Other | NY | MEDICARE GROUP HR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 209465 (New York) | Primary |
| Entity Name | North Shore-lij Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Zack, MD 1333 Roanoke Ave, Riverhead, NY 11901 Ph: (631) 727-2755 | Justin Zack, MD 1333 Roanoke Ave, Riverhead, NY 11901 Ph: (631) 727-2755 |
Barry Armandi, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1333 Roanoke Ave, Riverhead, NY 11901 Phone: 631-727-2755 Fax: 631-208-9521 | |
Dr. Isamettin Aral, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 896 Old Country Rd, Riverhead, NY 11901 Phone: 631-727-5469 | |
David Gross, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1333 Roanoke Ave, Riverhead, NY 11901 Phone: 631-727-2755 Fax: 631-208-9521 | |
David Kirshy, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1333 Roanoke Ave, Riverhead, NY 11901 Phone: 631-727-2755 Fax: 631-208-9521 | |
Dr. Renu Hausen, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1333 Roanoke Ave, Riverhead, NY 11901 Phone: 631-727-2755 Fax: 631-208-9521 | |
Robert Goodman, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1333 Roanoke Ave, Riverhead, NY 11901 Phone: 631-727-2755 Fax: 631-727-2852 | |
Tyana Raynor, D.O. Radiology Medicare: Medicare Enrolled Practice Location: 1300 Roanoke Ave, Riverhead, NY 11901 Phone: 631-548-6446 Fax: 631-727-0772 |