Organization
WOODLAND PARK DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
1225 MCBRIDE AVE, WOODLAND PARK, NJ 07424-2540
(973) 890-2394
(973) 890-2649
Mailing address
1225 MCBRIDE AVE, WOODLAND PARK, NJ 07424-2540
(973) 890-2394
(973) 890-2649
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
—
0266485
—
NJ
Enumeration date
09/10/2010
Last updated
01/10/2023
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