Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
26 RESEARCH WAY, EAST SETAUKET, NY 11733-3453
(631) 444-0502
(631) 444-0187
Mailing address
26 RESEARCH WAY, EAST SETAUKET, NY 11733-3453
(631) 444-0502
(631) 444-0187
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
5151205R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01799288
—
NY
Enumeration date
07/08/2006
Last updated
10/05/2023
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