Organization
KNICKERBOCKER DIALYSIS INC
Active
Other names
Seaway Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
999 E RIDGE RD, STE 11, ROCHESTER, NY 14621-1936
(585) 266-7348
(585) 266-4685
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
—
04935008
—
NY
Enumeration date
01/04/2017
Last updated
05/01/2024
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