SOUTH QUEENS DIALYSIS CENTER NPI 1205957446

NPI Information

SOUTH QUEENS DIALYSIS CENTER is an end-stage renal disease (esrd) treatment clinic center in Jamaica, NY. SOUTH QUEENS DIALYSIS CENTER NPI is 1205957446. The provider is registered as an organization entity type.
The provider Is Doing Business As South Queens Dialysis Center.

The provider's business location address is:

17537 LIBERTY AVE
JAMAICA, NY
ZIP 11433-325
Phone: (718) 297-9100
Fax: (718) 297-0625

The provider's authorized official is Robert Slifkin .
The authorized official title is Owner and has the following contact phone number (516) 626-8947.

The CLIA number assigned to this NPI record is 33D1020585 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 9/17/2009.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.