Organization
LONG ISLAND RENAL CARE INC
Active
Other names
LONG ISLAND R C INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREY GONCHARUK M.D. (PRESIDENT)
(631) 532-6969
Entity
Organization
Contact information
Practice address
3460 GREAT NECK RD, AMITYVILLE, NY 11701-1915
(631) 532-6969
(631) 532-6968
Mailing address
3460 GREAT NECK RD, AMITYVILLE, NY 11701-1915
(631) 532-6969
(631) 532-6968
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
5120201R
NY
Other
Enumeration date
03/27/2009
Last updated
01/27/2010
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