Organization
GOOD SAMARITAN HOSPITAL
Active
Other names
Weiss Renal
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SCHNEIDERS (EVP)
(845) 368-5303
Entity
Organization
Contact information
Practice address
255 LAFAYETTE AVE, SUFFERN, NY 10901-4812
(845) 368-5000
(845) 987-2348
Mailing address
255 LAFAYETTE AVE, SUFFERN, NY 10901-4812
(845) 368-5000
(845) 987-2348
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
01
—
000153
BLUE CROSS
NY
05
—
00273941
—
NY
Enumeration date
11/02/2006
Last updated
12/13/2010
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