Organization
PARK AVENUE DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RAUSMAN (OWNER)
(212) 426-1284
Entity
Organization
Contact information
Practice address
116 E 125TH ST, NEW YORK, NY 10035-1612
(212) 426-1284
Mailing address
116-122 EAST 124TH STREET, NEW YORK, NY 10035
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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