Healthcare Provider Details

I. General information

NPI: 1033384144
Provider Name (Legal Business Name): ZILKHA RADIOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 MONTAUK HWY
WEST ISLIP NY
11795-4930
US

IV. Provider business mailing address

1161 MONTAUK HWY
WEST ISLIP NY
11795-4930
US

V. Phone/Fax

Practice location:
  • Phone: 631-277-1600
  • Fax: 631-277-1638
Mailing address:
  • Phone: 631-277-1600
  • Fax: 631-277-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALBERT ZILKHA
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 631-277-1600