| NPI | 1730409301 |
|---|---|
| Doing Business As | 4102-13TH AVENUE MANAGEMENT, LLC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHTERN Administrator, CEO 718-258-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2010-06-07 |