Organization
EMPIRE STATE DC INC
Active
Other names
Ithaca Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
201 DATES DR, STE 206, ITHACA, NY 14850-1345
(607) 272-1693
(607) 273-5580
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
—
01909677
—
NY
Enumeration date
06/23/2006
Last updated
01/15/2026
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