JUSTIN ZACK MD NPI 1407964695

NPI Information

NPI: 1407964695
Provider Name: JUSTIN ZACK, MD
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
1333 ROANOKE AVE
RIVERHEAD, NY
ZIP 11901
Phone: (631) 727-2755
Get Directions

Justin Zack, MD is a vascular and interventional radiology radiology in Riverhead, NY. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. Justin Zack, MD NPI is 1407964695. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1333 ROANOKE AVE
RIVERHEAD, NY
ZIP 11901
Phone: (631) 727-2755
Fax: (631) 208-9521

The NPI 1407964695 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/28/2006 and was last updated on 5/16/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology	209465	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W22111	OTHER	NEW YORK	MEDICARE GROUP SHR
2	W11401	OTHER	NEW YORK	BC/BS
3	503431	MEDICARE PIN	NEW YORK
4	02206999	MEDICAID	NEW YORK
5	CF3402	OTHER	NEW YORK	RR MEDICARE
6	WEU091	OTHER	NEW YORK	MEDICARE GROUP HR
7	H42722	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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