VESTAL HEALTHCARE LLC NPI 1952768640

NPI Information

NPI: 1952768640
Provider Name: VESTAL HEALTHCARE, LLC

Doing Business As: FREEDOM CENTER OF BRONX

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1776 EASTCHESTER RD
2ND FLOOR
BRONX, NY
ZIP 10461
Phone: (718) 239-2089
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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 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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			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: 11/14/2023

NPI Synchronization or Removal

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