Organization
ROCKAWAY HD LLC
Active
Other names
Rockaway Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLUSEGUN OGUNFOWORA M.D (CEO)
(718) 327-4503
Entity
Organization
Contact information
Practice address
529 BEACH 20TH ST, 1ST FLOOR, FAR ROCKAWAY, NY 11691-3645
(718) 327-7307
(718) 327-3297
Mailing address
529 BEACH 20TH STREET, 1ST FLOOR, FAR ROCKAWAY, NY 11691-3645
(718) 327-4503
(718) 327-0043
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
206115
NY
Other
Enumeration date
05/18/2012
Last updated
07/17/2012
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