EAST END DIALYSIS MANAGEMENT LLC NPI 1780891648

NPI Information

  • NPI: 1780891648
  • Provider Name: EAST END DIALYSIS MANAGEMENT, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • CLIA Number: 33D2123813
  • Address: 792 HARRISON AVE
    SOUTH BUILDING
    RIVERHEAD, NY
    ZIP 11901
  • Phone: (718) 483-7440

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NPI Details

EAST END DIALYSIS MANAGEMENT, LLC is an end-stage renal disease (esrd) treatment clinic center in Riverhead, NY. EAST END DIALYSIS MANAGEMENT, LLC NPI is 1780891648. The provider is registered as an organization entity type.

The provider's business location address is:

792 HARRISON AVE
SOUTH BUILDING
RIVERHEAD, NY
ZIP 11901-744
Phone: (718) 483-7440

The provider's authorized official is J. Ganesh Bhat .
The authorized official title is President and has the following contact phone number (718) 366-1111.

The CLIA number assigned to this NPI record is 33D2123813 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 3/4/2015.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1332658MEDICARE OSCAR/CERTIFICATIONNEW YORK

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: 3/30/2025

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