Organization
PHYSICIANS DIALYSIS PASSAIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY J BOOTH (CEO)
(305) 651-3261
Entity
Organization
Contact information
Practice address
10 CLIFTON BLVD, CLIFTON, NJ 07011-3802
(973) 594-9100
Mailing address
19559 NE 10TH AVE, NORTH MIAMI BEACH, FL 33179-3501
(305) 651-3261
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
22618
NJ
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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