MAIN STREET DIALYSIS CENTER LLC (NPI# 1306203609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306203609 |
| Entity Type | Organization |
| Organization Name | MAIN STREET DIALYSIS CENTER LLC |
| Practice Address |
3 N Main St Freeport NY 11520-2218 |
| Mailing Address |
Po Box 037216 Elmont NY 11003-7216 |
| Practice Telephone | 5168252076 |
| Mailing Telephone | 5168252076 |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |
| Authorized Official Name | DR. IHEANYICHUKWU AJA-ONU (MEMBER) |
| Authorized Official Telephone | 5168252076 |
| 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 |
052083-B | NY | Ambulatory Health Care Facilities |
| Street Address |
3 N MAIN ST |
| City | FREEPORT |
| State | NY |
| Zip Code | 11520-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881157154 | Barbara Chillemi | Registered Nurse | 56 Mackay Place, Freeport, NY 11520 | 2019-04-12 |
| 1588171631 | Lisa Frank | Nurse Practitioner | 150 Buffalo Ave, Freeport, NY 11520 | 2018-01-10 |
| 1447775838 | Julner Quettant Jr. | Physical Therapist | 63 St Marks Ave, Freeport, NY 11520 | 2017-08-07 |
| 1679003933 | Candice A R Greene | Speech-Language Pathologist | 12 Summers Place, Freeport, NY 11520 | 2017-06-19 |
| 1700310331 | Samantha Edwards | Psychologist | 6 Delisle Avenue, Freeport, NY 11520 | 2017-04-20 |
| 1275073769 | Dorothea Geiger | Behavior Technician | 90 Hillside Ave, Freeport, NY 11520 | 2017-03-02 |
| 1477092575 | Maryhaven Center of Hope,inc | Substance Abuse Rehabilitation Facility | 150 Buffalo Avenue, Freeport, NY 11520 | 2017-02-22 |
| 1861849135 | Daniel Lora | Acupuncturist | 140 Parsons Ave, Freeport, NY 11520 | 2016-05-17 |
| 1326413790 | Beatrice Jeanty | Registered Nurse | 619 South Long Beach Ave., Freeport, NY 11520 | 2015-12-10 |
| 1134505548 | Maria A. Meek | Nurse Practitioner | 334, West Merrick Rd., Freeport., NY 11520 | 2015-08-07 |
| Find all providers in zip 11520 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
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|---|---|---|---|---|
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| 1225300056 | Freeportbay Dialysis LLC | Clinic/Center | 1808 S West Ave, Freeport, IL 61032-6712 | 2012-02-09 |
| 1740216159 | Huntington Artificial Kidney Center Ltd | Clinic/Center | 351 S Main St, Freeport, NY 11520-5114 | 2006-06-25 |
| 1568431864 | Renal Treatment Centers-illinois Inc | Clinic/Center | 1028 S Kunkle Blvd, Freeport, IL 61032-6914 | 2006-03-17 |
| 1265697643 | Davita of New York Inc | Clinic/Center | 267 W Merrick Rd, Freeport, NY 11520-3346 | 2008-07-24 |
| 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.