SOUTH QUEENS DIALYSIS CENTER (NPI# 1205957446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205957446 |
| Entity Type | Organization |
| Organization Name | SOUTH QUEENS DIALYSIS CENTER |
| Other Organization Name | SOUTH QUEENS DIALYSIS CENTER |
| Practice Address |
17537 Liberty Ave Jamaica NY 11433-1325 |
| Practice Telephone | 7182979100 |
| Practice Fax Number | 7182970625 |
| Mailing Telephone | 7182979100 |
| Mailing Fax Number | 7182970625 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2009-09-17 |
| Authorized Official Name | DR. ROBERT SLIFKIN (OWNER) |
| Authorized Official Telephone | 5166268947 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| South Queens Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508988213 | South Queens Dialysis Center | Clinic/Center | 17270 Baisley Blvd, Jamaica, NY 11434-2615 | 2007-04-04 |
| Street Address |
17537 LIBERTY AVE |
| City | JAMAICA |
| State | NY |
| Zip Code | 11433-1325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255316246 | South Queens Nephrology Associates | Specialist | 17537 Liberty Ave, Jamaica, NY 11433-1325 | 2005-12-13 |
| 1487971511 | New York Dialysis Services, Inc. | Clinic/Center | 17537 Liberty Ave, Jamaica, NY 11433-1325 | 2010-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245849710 | Smana Seradieu | Social Worker | 109 16 176th Street Jamaica, 109 16 176th Street Jamaica, Queens, NY 11433 | 2020-07-30 |
| 1336610716 | Dian Ann Scarlet | Specialist | 89-28 Merrick Blvd, Jamaica, NY 11433 | 2018-12-11 |
| 1609368158 | Angela I Frazier | Counselor | 168-20 Liberty Avenue #2, Jamaica, NY 11433 | 2018-05-31 |
| 1346759453 | Cecilia Vellozo | Speech-Language Pathologist | P.s. 48 William Wordsworth School, 10829 155th St, Jamaica, NY 11433 | 2017-09-21 |
| 1942723648 | Cheron Johnson | Behavior Technician | 107-29 172nd Street, Jamaica, NY 11433 | 2017-07-25 |
| 1093237208 | Bal & Dhamija Inc | Pharmacy | 107-45 Guy Brewer Blvd, Jamaica, NY 11433 | 2017-07-10 |
| 1962931311 | Emily Sheppard | Behavioral Analyst | 17326 113 Ave, Jamaica, NY 11433 | 2017-06-08 |
| 1497288310 | Ana Martinez | Licensed Practical Nurse | 176-08 108 Road, Brooklyn, NY 11433 | 2017-04-07 |
| 1336680313 | Shirley Joseph-ross | Psychologist | 109-46 172nd Street, Jamaica, NY 11433 | 2017-03-10 |
| 1346787116 | Jennifer Jenine Griffith | Behavior Technician | 11307 175th St., Jamaica, NY 11433 | 2017-01-31 |
| Find all providers in zip 11433 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942792239 | Knickerbocker Dialysis Inc | Clinic/Center | 9130 Van Wyck Expy, Jamaica, NY 11418-2822 | 2018-06-01 |
| 1942654694 | Knickerbocker Dialysis Inc | Clinic/Center | 171-19 Hillside Ave, Jamaica, NY 11432-4548 | 2016-04-19 |
| 1811214976 | New York Dialysis Services, Inc. | Clinic/Center | 172-70 Baisley Blvd., Jamaica, NY 11434-2615 | 2010-04-29 |
| 1508988213 | South Queens Dialysis Center | Clinic/Center | 17270 Baisley Blvd, Jamaica, NY 11434-2615 | 2007-04-04 |
| 1871520361 | Knickerbocker Dialysis Inc | Clinic/Center | 11801 Guy R Brewer Blvd, Jamaica, NY 11434-2101 | 2006-06-28 |
| 1487971511 | New York Dialysis Services, Inc. | Clinic/Center | 17537 Liberty Ave, Jamaica, NY 11433-1325 | 2010-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194323071 | True North Dialysis Center LLC | Clinic/Center | 668 Middle Country Rd, Selden, NY 11784-2521 | 2020-10-13 |
| 1952908386 | Ulster Dialysis, LLC | Clinic/Center | 900 Miron Ln, Kingston, NY 12401-1567 | 2020-10-08 |
| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 1043839269 | Knickerbocker Dialysis Inc | Clinic/Center | 5518 Avenue N, Brooklyn, NY 11234-4006 | 2020-04-09 |
| 1942839378 | Knickerbocker Dialysis Inc | Clinic/Center | 479 E Main St, Patchogue, NY 11772-3147 | 2020-04-07 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1629617576 | Knickerbocker Dialysis Inc | Clinic/Center | 1633 Route 202 Ste 120, Pomona, NY 10970-2926 | 2019-12-24 |
| 1740824184 | Knickerbocker Dialysis Inc | Clinic/Center | 11 Romaine Ave, Yonkers, NY 10705 | 2019-10-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.