KNICKERBOCKER DIALYSIS INC (NPI# 1407415243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407415243 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Practice Address |
931 Bruckner Blvd Bronx NY 10459-4525 |
| Mailing Address |
5200 Virginia Way L and C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7183780921 |
| Practice Fax Number | 7183781423 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153204414 |
| 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 |
|---|---|
| Longwood 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 |
| 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 |
| Street Address |
931 BRUCKNER BLVD |
| City | BRONX |
| State | NY |
| Zip Code | 10459-4525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912508458 | Sterling Smiles LLC | Dentist | 1022 E163rd St, Bronx, NY 10459 | 2020-11-02 |
| 1710496633 | Vitus C. Ezerioha | Licensed Practical Nurse | 870 Southern Blvd., Apt 1a, Bronx, NY 10459 | 2017-09-22 |
| 1790208403 | Jessica S Lee | Early Intervention Provider Agency | 985 Intervale Ave Apt. 2c, Bronx, NY 10459 | 2017-07-25 |
| 1669901070 | Ruthlyn Merrick | Registered Nurse | 1466 Louis Nine Blvd, Bronx, NY 10459 | 2017-06-08 |
| 1154865681 | John Wahl | Speech-Language Pathologist | 977 Fox St., Is 217, Bronx, NY 10459 | 2016-12-19 |
| 1801349675 | Aneesa Ible | Social Worker | 953 Southern Blvd, Suite 301, Odyssey House Inc., Bronx, NY 10459 | 2016-07-28 |
| 1457711277 | Agboade Ademiju | Registered Nurse | 900 Intervale Ave, Archcare, Bronx, Bronx, NY 10459 | 2016-03-07 |
| 1952760076 | Apollo Radio Dispatcher | Taxi | 801 Freeman Street, Bronx, NY 10459 | 2016-02-17 |
| 1730547522 | Foxhurst Medical of New York LLC | Surgery | 947 Southern Blvd Ste B, Bronx, NY 10459 | 2016-02-08 |
| 1063892388 | Vismar Radio Dispatch Inc. | Taxi | 1040-52 Freeman St, Bronx, NY 10459 | 2015-06-02 |
| Find all providers in zip 10459 | ||||
| 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 |
|---|---|---|---|---|
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1902456742 | Knickerbocker Dialysis Inc | Clinic/Center | 34 Marconi St Ste 110, Bronx, NY 10461-2755 | 2019-09-13 |
| 1700353943 | New York Dialysis Services Inc | Clinic/Center | 1776 Eastchester Rd Ste 240, Bronx, NY 10461-2335 | 2018-10-25 |
| 1730676743 | Knickerbocker Dialysis Inc | Clinic/Center | 1820 E Tremont Ave, Bronx, NY 10460-3131 | 2018-04-16 |
| 1013410133 | Knickerbocker Dialysis Inc | Clinic/Center | 2190 Jerome Ave, Bronx, NY 10453-1815 | 2018-03-15 |
| 1063911659 | Knickerbocker Dialysis Inc | Clinic/Center | 1490 Macombs Rd, Bronx, NY 10452-2101 | 2018-02-08 |
| 1275032856 | Knickerbocker Dialysis Inc | Clinic/Center | 2554 White Plains Rd, Bronx, NY 10467-8141 | 2018-02-08 |
| 1063932945 | Knickerbocker Dialysis Inc | Clinic/Center | 3440 Boston Rd, Bronx, NY 10469-2512 | 2017-06-22 |
| 1962957993 | Knickerbocker Dialysis Inc | Clinic/Center | 2331 Eastchester Rd, Bronx, NY 10469-5910 | 2016-08-19 |
| 1033582283 | Usrc Pelham, LLC | Clinic/Center | 1225a Morris Park Ave, Bronx, NY 10461-1929 | 2015-11-10 |
| Find all providers in BRONX | ||||
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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.