Organization
HERALD SQUARE DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
1 HERALD SQ, SUITE 100, NEW BRITAIN, CT 06051-5006
(860) 223-4963
(860) 223-4965
Mailing address
1 HERALD SQ, SUITE 100, NEW BRITAIN, CT 06051-5006
(860) 223-4963
(860) 223-4965
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
—
008068757
—
CT
Enumeration date
03/14/2016
Last updated
01/10/2023
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