| NPI | 1790779114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC LICCIARDI Administrator 718-437-1594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2022-07-21 |