VESTAL HEALTHCARE LLC NPI 1952768640

NPI Information

  • NPI: 1952768640
  • Provider Name: VESTAL HEALTHCARE, LLC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: FREEDOM CENTER OF BRONX
  • CLIA Number: 33D2111197
  • Address: 1776 EASTCHESTER RD
    2ND FLOOR
    BRONX, NY
    ZIP 10461
  • Phone: (718) 239-2089

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NPI Details

VESTAL HEALTHCARE, LLC is an end-stage renal disease (esrd) treatment clinic center in Bronx, NY. VESTAL HEALTHCARE, LLC NPI is 1952768640. The provider is registered as an organization entity type.
The provider Is Doing Business As Freedom Center Of Bronx.

The provider's business location address is:

1776 EASTCHESTER RD
2ND FLOOR
BRONX, NY
ZIP 10461-341
Phone: (718) 239-2089
Fax: (718) 239-2385

The provider's authorized official is Mark Caputo .
The authorized official title is President and has the following contact phone number (781) 699-9000.

The CLIA number assigned to this NPI record is 33D2111197 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2016 and was last updated on 3/1/2016.

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

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: 11/21/2025

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