Organization
MILLS POND DIALYSIS CENTER, LLC
Active
Other names
Cassena Kidney Care at East Neck
Organization subpart
No
Provider details
NPI number
Authorized official
PASQUALE DEBENEDICTIS (MANAGER / MEMBER)
(516) 422-7818
Entity
Organization
Contact information
Practice address
134 GREAT EAST NECK RD, WEST BABYLON, NY 11704-8027
(516) 422-4800
Mailing address
134 GREAT EAST NECK RD, WEST BABYLON, NY 11704-8027
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332731
CCN
—
Enumeration date
11/24/2014
Last updated
06/12/2024
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