Organization
KNICKERBOCKER DIALYSIS INC
Active
Other names
Northtowns Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (ASSISTANT SECRETARY)
(615) 341-6641
Entity
Organization
Contact information
Practice address
4041 DELAWARE AVE, STE 150, TONAWANDA, NY 14150-6828
(716) 871-8103
(716) 871-8107
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
—
03010079
—
NY
Enumeration date
12/27/2012
Last updated
03/06/2026
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