LONG ISLAND RENAL CARE INC (NPI# 1447492079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447492079 |
| Entity Type | Organization |
| Organization Name | LONG ISLAND RENAL CARE INC |
| Other Organization Name | LONG ISLAND R C INC |
| Practice Address |
3460 Great Neck Rd Amityville NY 11701-1915 |
| Practice Telephone | 6315326969 |
| Practice Fax Number | 6315326968 |
| Mailing Telephone | 6315326969 |
| Mailing Fax Number | 6315326968 |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2010-01-27 |
| Authorized Official Name | DR. ANDREY GONCHARUK (PRESIDENT) |
| Authorized Official Telephone | 6315326969 |
| 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 |
5120201R | NY | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| LONG ISLAND R C INC | Former Legal Business Name - Organization |
| Street Address |
3460 GREAT NECK RD |
| City | AMITYVILLE |
| State | NY |
| Zip Code | 11701-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457774002 | Knickerbocker Dialysis Inc | Clinic/Center | 3460 Great Neck Rd, Amityville, NY 11701-1915 | 2014-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013427400 | Katya Cabrera | Licensed Practical Nurse | 8 Coolidge Ave, North Amityville, NY 11701 | 2017-10-11 |
| 1750800405 | Laura M Sabatino-jan | Nurse Practitioner | 65 S. Emerson Avenue, Amity Harbor, NY 11701 | 2017-09-13 |
| 1104355536 | Massapequa Center LLC | Skilled Nursing Facility | 101 Louden Ave., Amityville, NY 11701 | 2017-06-08 |
| 1588193874 | Allison Herzog | Specialist | 41 Terry Avenue, Amityville, NY 11701 | 2017-06-08 |
| 1962949677 | Sherlin Golbari | Physician Assistant | 317 Broadway Suite A, Amytyville, NY 11701 | 2017-01-20 |
| 1598129710 | Yoko Shiraiwa | Nurse Practitioner | 78 Ocean Avenue, Amityville, NY 11701 | 2016-04-13 |
| 1891158820 | Grace Ann Budde | Health Educator | 30 S Ireland Pl, Amityville, NY 11701 | 2016-03-29 |
| 1720445497 | Sabrina A Rahman | Pharmacist | 355 A Broadway, Amityville, NY 11701 | 2016-01-26 |
| 1902245335 | Darlene Marie Mccurty | Specialist | 125 Larsen Dr, Amityville, NY 11701 | 2013-06-19 |
| 1457613507 | Edria Parks | Specialist | 14 Wanser Pl, Amityville, NY 11701 | 2012-06-14 |
| Find all providers in zip 11701 | ||||
| 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 |
|---|---|---|---|---|
| 1457774002 | Knickerbocker Dialysis Inc | Clinic/Center | 3460 Great Neck Rd, Amityville, NY 11701-1915 | 2014-01-31 |
| 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 | AMITYVILLE |
| Zip Code | 11701 |
Please comment or provide details below to improve the information on LONG ISLAND RENAL CARE 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.