Organization
COMPREHENSIVE DIALYSIS CENTER OF WESTERN NEW YORK, INC.
Active
Other names
CDCWNY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMESH KOHLI M.D. (MEDICAL DIRECTOR)
(716) 631-4700
Entity
Organization
Contact information
Practice address
6010 MAIN ST, WILLIAMSVILLE, NY 14221-6837
(716) 631-4700
(716) 631-4711
Mailing address
6010 MAIN ST, WILLIAMSVILLE, NY 14221-6837
(716) 631-4700
(716) 631-4711
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
121592-1
NY
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
144330-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011420401
UNIVERA PROVIDER NUMBER
NY
05
—
01502987
—
NY
01
—
359
BSBSWNY PROVIDER NUMBER
NY
01
—
B4
IHA PROVIDER NUMBER
NY
Enumeration date
06/17/2005
Last updated
12/08/2011
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