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
2649 STRANG BLVD STE 100, YORKTOWN HEIGHTS, NY 10598-2938
(914) 962-4005
(914) 962-3812
Mailing address
2649 STRANG BLVD STE 100, YORKTOWN HEIGHTS, NY 10598-2938
(914) 962-4005
(914) 962-3812
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
5957200R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03011025
—
NY
05
—
39204235
—
CO
Enumeration date
07/08/2006
Last updated
10/05/2023
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