Organization
QUEENS DIALYSIS AT THE PAVILION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL EDELSTEIN (MANAGER)
(718) 888-5206
Entity
Organization
Contact information
Practice address
36-17 PARSONS BLVD, FLUSHING, NY 11354-5931
(718) 961-4300
Mailing address
36-17 PARSONS BLVD, FLUSHING, NY 11354-5931
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2991431
—
NY
Enumeration date
12/16/2014
Last updated
08/14/2024
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