KNICKERBOCKER DIALYSIS INC


Address: 860 Grand Blvd, Deer Park, NY 11729-5706
Phone: 6312437770

KNICKERBOCKER DIALYSIS INC (NPI# 1386205714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386205714
Entity Type Organization
Organization Name KNICKERBOCKER DIALYSIS INC
Practice Address 860 Grand Blvd
Deer Park
NY 11729-5706
Mailing Address 5200 Virginia Way
L and C Dept
Brentwood
TN 37027-7569
Practice Telephone 6312437770
Practice Fax Number 6312437775
Mailing Telephone 6153204414
Mailing Fax Number 8668652884
Enumeration Date 2019-06-26
Last Update Date 2019-06-26
Authorized Official Name JAMES HILGER (CHIEF ACCOUNTING OFFICER)
Authorized Official Telephone 6153204414
Is Organization Subpart N

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Grand Boulevard Dialysis Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1043839269 Knickerbocker Dialysis Inc Clinic/Center 5518 Avenue N, Brooklyn, NY 11234-4006 2020-04-09
1679192876 Knickerbocker Dialysis Inc Clinic/Center 1734 Hancock St, Ridgewood, NJ 11385-4734 2020-04-09
1942839378 Knickerbocker Dialysis Inc Clinic/Center 479 E Main St, Patchogue, NY 11772-3147 2020-04-07
1205461639 Knickerbocker Dialysis Inc Clinic/Center 1277 Middle Country Rd, Middle Island, NY 11953 2020-03-05
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
1902456742 Knickerbocker Dialysis Inc Clinic/Center 34 Marconi St Ste 110, Bronx, NY 10461-2755 2019-09-13
1407415243 Knickerbocker Dialysis Inc Clinic/Center 931 Bruckner Blvd, Bronx, NY 10459-4525 2019-06-06
1306404926 Knickerbocker Dialysis Inc Clinic/Center 203 W Route 59, Nanuet, NY 10954-2218 2019-05-29
1487133633 Knickerbocker Dialysis Inc Clinic/Center 54 New Lots Ave, Brooklyn, NY 11212-6934 2018-08-08

Office Location

Street Address 860 GRAND BLVD
City DEER PARK
State NY
Zip Code 11729-5706

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013561513 Elyse Joy Wright Specialist 1014 Grand Boulevard Suite 5, Deer Park, NY 11729 2019-08-01
1568929131 Corrine E. Hibbert Case Manager/Care Coordinator 140 Villa Avenue, Deer Park Ny, NY 11729 2019-03-01
1922525286 Melissa Ramistella Behavioral Analyst 6 Angelica Street, Deer Park, NY 11729 2017-08-28
1609224153 Corvitals, Inc. Clinical Medical Laboratory 590 Nichols Road, Suite 1, Deer Park, NY 11729 2016-05-25
1417375312 Venel Maitre Registered Nurse 54 Duke St, Deer Park, NY 11729 2014-03-29
1578819157 Koa K Robinson Registered Nurse 375 Carlls Place, 329, Deer Park, NY 11729 2012-08-01
1649532409 Theresa L Lerro Counselor 1 Brandyine Drive, Deer Park, NY 11729 2012-06-07
1417218827 Abilities Unlimited of N.y. Durable Medical Equipment & Medical Supplies 90 E. Jefryn Blvd., Deer Park, NY 11729 2012-06-01
1356600811 Jennifer A. D'auria Speech-Language Pathologist 101 Lake Ave., Jfk Intermediate School, Deer Park, NY 11729 2012-05-03
1013280254 Usv Optical Inc. Eyewear Supplier (Equipment, not the service) 1900 The Arches Circle, Deer Park, NY 11729 2012-02-20
Find all providers in zip 11729

Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1841574746 Inland Northwest Renal Care Group LLC Clinic/Center 822 S. Main Street, Deer Park, WA 99006-8242 2011-10-11
1144332032 Bio-medical Applications of Texas, Inc. Clinic/Center 4625 Center St, Deer Park, TX 77536-6352 2006-08-31

Providers in the same taxonomy and state

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

Competitor

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City DEER PARK
Zip Code 11729

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Dataset Information

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.

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