Organization
REPLACEMENT ASSOCIATES LLC
Active
Other names
Upper Eastside Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINIC LICCIARDI (ADMINISTRATOR)
(718) 987-5942
Entity
Organization
Contact information
Practice address
210 E 86TH ST 3RD FLOOR, NEW YORK, NY 10028-3003
(212) 794-2850
(212) 794-2187
Mailing address
97 NEW DORP LN, STATEN ISLAND, NY 10306-2364
(718) 448-5641
(718) 876-5969
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
7002180R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00519755
—
NY
05
—
02717999
—
NY
Enumeration date
11/02/2005
Last updated
10/12/2023
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