VESTAL HEALTHCARE LLC NPI 1083005573

NPI Information

NPI: 1083005573
Provider Name: VESTAL HEALTHCARE LLC

Doing Business As: FREEDOM CENTER OF QUEENS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
17627 UNION TPKE
FRESH MEADOWS, NY
ZIP 11366
Phone: (718) 969-3293
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VESTAL HEALTHCARE LLC is an end-stage renal disease (esrd) treatment clinic center in Fresh Meadows, NY. VESTAL HEALTHCARE LLC NPI is 1083005573. The provider is registered as an organization entity type.
The provider Is Doing Business As Freedom Center Of Queens.

The provider's business location address is:

17627 UNION TPKE
FRESH MEADOWS, NY
ZIP 11366-515
Phone: (718) 969-3293
Fax: (718) 969-3927

The provider's authorized official is Mark Caputo .
The authorized official title is President and has the following contact phone number (206) 816-6505.

The enumeration date for this NPI number is 2/5/2015 and was last updated on 10/27/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment		NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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