Organization
KNICKERBOCKER DIALYSIS INC
Active
Other names
Port Washington Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 733-4500
Entity
Organization
Contact information
Practice address
50 SEAVIEW BLVD, PORT WASHINGTON, NY 11050-4618
(516) 484-3460
(516) 484-7949
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 320-4414
(866) 865-2884
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
—
03049052
—
NY
Enumeration date
06/18/2006
Last updated
05/08/2015
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