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Organization

NEW HYDE PARK DIALYSIS CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
J. GANESH BHAT MD (PRESIDENT)
(718) 366-1111
Entity
Organization

Contact information

Practice address
1574 HILLSIDE AVE, NEW HYDE PARK, NY 11040-2527
(516) 327-5555
(516) 327-5556
Mailing address
23-14 COLLEGE POINT BLVD, COLLEGE POINT, NY 11356-2526
(516) 327-5555
(516) 327-5556

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
2912200R
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02176956
NY
01
023901
EMPIRE BCBS
NY
Enumeration date
07/18/2005
Last updated
03/04/2015
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