Organization
RENAL CENTERS OF NORTH JERSEY, LLC
Active
Organization
RENAL CENTERS OF NORTH JERSEY, LLC
Active
Other names
LINCOLN PARK DIALYSIS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY GREEN (SECRETARY)
(562) 495-8075
Entity
Organization
Contact information
Practice address
6 FRASSETTO WAY, A, LINCOLN PARK, NJ 07035-2058
(973) 872-0099
(973) 872-0230
Mailing address
1 WORLD TRADE CTR, 2500, LONG BEACH, CA 90831-0002
(562) 495-8075
(562) 495-8076
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
22359
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6820301
—
NJ
Enumeration date
01/30/2006
Last updated
08/22/2020
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