KNICKERBOCKER DIALYSIS INC (NPI# 1396285045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396285045 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | OZONE PARK DIALYSIS |
| Practice Address |
100-02 Rockaway Blvd Ozone Park NY 11417-2217 |
| Mailing Address |
5200 Virginia Way L & C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7188430694 |
| Practice Fax Number | 7183232438 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2020-03-27 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 05400959 | 05 |
| Other Name | Type Code |
|---|---|
| Ozone Park Dialysis | Doing Business As Name - Organization |
| 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 |
| 1386205714 | Knickerbocker Dialysis Inc | Clinic/Center | 860 Grand Blvd, Deer Park, NY 11729-5706 | 2019-06-26 |
| 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 |
| Street Address |
100-02 ROCKAWAY BLVD |
| City | OZONE PARK |
| State | NY |
| Zip Code | 11417-2217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757723 | Raymond Videsh Seelochan | Physician Assistant | 105-14 91st Street, Ozone Park, NY 11417 | 2020-07-21 |
| 1942778907 | All Medical Equipments Inc | Durable Medical Equipment & Medical Supplies | 10621 97th St Unit Bc, Ozone Park, NY 11417 | 2018-11-08 |
| 1871085696 | Jellybean Ei Inc. | Case Management | 13524 96th St, Ozone Park, NY 11417 | 2018-06-06 |
| 1093238180 | Goydan Pharmacy Inc | Pharmacy | 150-29 Cross Bay Blvd, Store 1, Ozone Park, NY 11417 | 2017-07-20 |
| 1326585183 | Quest Pharmacy Corp | Pharmacy | 150-29 Cross Bay Blvd Store 1, Ozone Park, NY 11417 | 2017-01-31 |
| 1609319441 | Alexandra Musacchio | Speech-Language Pathologist | 104-50 102nd St, 2e, Ozone Park, NY 11417 | 2016-11-28 |
| 1083166805 | Danielle Natman | Social Worker | 108-19 Rockaway Boulevard, Ozone Park, NY 11417 | 2016-10-27 |
| 1487018388 | Antonia Diaz | Registered Nurse | 107-46 90th Street, 2nd Floor, Ozone Park, NY 11417 | 2016-04-07 |
| 1871967901 | Ngozi Ezinne Inwelegbu | Licensed Practical Nurse | 133-25 87th Street, 2b, Ozone Park, NY 11417 | 2015-12-01 |
| 1073982815 | Stop and Shop Supermarket Co LLC | Durable Medical Equipment & Medical Supplies | 92-10 Atlantic Ave, Ozone Park, NY 11417 | 2015-09-23 |
| Find all providers in zip 11417 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
| City | OZONE PARK |
| Zip Code | 11417 |
Please comment or provide details below to improve the information on KNICKERBOCKER DIALYSIS INC.
| 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.