Organization
ST. JOSEPH'S DIALYSIS , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD JIMENEZ (PRESIDENT)
(973) 754-2925
Entity
Organization
Contact information
Practice address
57 WILLOWBROOK BLVD, 2ND FLOOR, WAYNE, NJ 07470-7045
(973) 754-4092
(973) 754-4049
Mailing address
57 WILLOWBROOK BLVD, 2ND FLOOR, WAYNE, NJ 07470-7045
(973) 754-4092
(973) 754-4049
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2009
Last updated
11/04/2009
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