National Provider Identifier Database

JUSTIN ZACK, MD – NPI #1407964695
Vascular & Interventional Radiology

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.


Contact Information

JUSTIN ZACK, MD
1333 ROANOKE AVE
RIVERHEAD, NY11901
Phone: 631-727-2755
Fax: 631-208-9521
Website:
Specialty Taxonomy Code
* Vascular & Interventional Radiology 2085R0204X

* Indicates primary specialty

NPI Profile & details for JUSTIN ZACK

NPI Number 1407964695
Credentials MD
Entity Individual
Enumeration date 08/28/2006
Last updated 05/16/2008 - About 18 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 209465
  • NY Medicaid: 02206999
  • NY Other: W11401 BC/BS
  • NY Other: WEU091 MEDICARE GROUP HR
  • NY Other: W22111 MEDICARE GROUP SHR
  • NY Other: CF3402 RR MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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