Organization
NEWYORK-PRESBYTERIAN-QUEENS
Active
Parent organization
NYP COMMUNITY PROGRAMS, INC.
Other names
Trude Weishaupt Memorial Satellite Dialysis Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
NYP COMMUNITY PROGRAMS, INC.
Authorized official
MRS. PHYLLIS R.F. LANTOS (EVP, CFO AND TREASURER)
(212) 746-7905
Entity
Organization
Contact information
Practice address
5928 174TH ST, FRESH MEADOWS, FRESH MEADOWS, NY 11365-1539
(718) 670-1276
Mailing address
5928 174TH ST, FRESH MEADOWS, FRESH MEADOWS, NY 11365-1539
(718) 670-1276
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
7003010H PFI 2670
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244133
—
NY
01
—
333547
MEDICARE PTAN
NY
Enumeration date
06/18/2006
Last updated
10/03/2022
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