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Organization

WESTERN QUEENS DIALYSIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFF GURKIN (VP - REMIBURSEMENT)
(347) 312-3034
Entity
Organization

Contact information

Practice address
3401 35TH AVE, ASTORIA, NY 11106-1222
(718) 707-9988
(718) 707-9830
Mailing address
2314 COLLEGE POINT BLVD, COLLEGE POINT, NY 11356-2526
(347) 312-3034
(347) 312-3042

Taxonomy

Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
7001256A
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02167953
NY
Enumeration date
02/15/2007
Last updated
08/22/2020
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