| NPI | 1669453502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC LICCIARDI Administrator 718-987-5942 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: NY 7004204R) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-09-28 |