Organization
KNICKERBOCKER DIALYSIS INC
Active
Other names
West Farms Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1820 E TREMONT AVE, BRONX, NY 10460-3131
(718) 824-0245
(718) 824-1775
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
—
06092635
—
NY
Enumeration date
04/16/2018
Last updated
01/12/2026
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