KNICKERBOCKER DIALYSIS INC – NPI #1205461639
Clinic/Center

KNICKERBOCKER DIALYSIS INC is an AHC clinic located in MIDDLE ISLAND, NY. NPPES has assigned the NPI number 1205461639 to KNICKERBOCKER DIALYSIS INC on March 05, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KNICKERBOCKER DIALYSIS INC below.

NPI Profile for
KNICKERBOCKER DIALYSIS INC

NPI Number
1205461639
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KNICKERBOCKER DIALYSIS INC
Primary location
1277 MIDDLE COUNTRY RD
MIDDLE ISLAND, NY 11953
Phone: (631) 205-0132 Fax: (631) 205-0171
Mailing address
5200 VIRGINIA WAY
L AND C DEPT
BRENTWOOD, TN 37027-7569
Phone: (615) 320-4414 Fax: (866) 865-2884
Organization Subpart
Yes - KNICKERBOCKER DIALYSIS INC is subpart of another organization.
Authorized Official
JOHN WINSTEL
CHIEF ACCOUNTING OFFICER
Phone: (615) 320-4414
Updated
Certification Date
Mar 05, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.