Organization
KNICKERBOCKER DIALYSIS INC
Active
Other names
Borough Park Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4102 13TH AVE, BROOKLYN, NY 11219-1389
(718) 435-2112
(718) 435-0354
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
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
—
03339457
—
NY
Enumeration date
02/09/2015
Last updated
04/08/2025
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