KNICKERBOCKER DIALYSIS INC (NPI# 1063932945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063932945 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | LACONIA DIALYSIS |
| Practice Address |
3440 Boston Rd Bronx NY 10469-2512 |
| Mailing Address |
5200 Virginia Way Brentwood TN 37027-7569 |
| Practice Telephone | 7187980538 |
| Practice Fax Number | 7186522495 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2017-06-22 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153204414 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Laconia Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839269 | Knickerbocker Dialysis Inc | Clinic/Center | 5518 Avenue N, Brooklyn, NY 11234-4006 | 2020-04-09 |
| 1679192876 | Knickerbocker Dialysis Inc | Clinic/Center | 1734 Hancock St, Ridgewood, NJ 11385-4734 | 2020-04-09 |
| 1942839378 | Knickerbocker Dialysis Inc | Clinic/Center | 479 E Main St, Patchogue, NY 11772-3147 | 2020-04-07 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1629617576 | Knickerbocker Dialysis Inc | Clinic/Center | 1633 Route 202 Ste 120, Pomona, NY 10970-2926 | 2019-12-24 |
| 1740824184 | Knickerbocker Dialysis Inc | Clinic/Center | 11 Romaine Ave, Yonkers, NY 10705 | 2019-10-29 |
| 1902456742 | Knickerbocker Dialysis Inc | Clinic/Center | 34 Marconi St Ste 110, Bronx, NY 10461-2755 | 2019-09-13 |
| 1386205714 | Knickerbocker Dialysis Inc | Clinic/Center | 860 Grand Blvd, Deer Park, NY 11729-5706 | 2019-06-26 |
| 1407415243 | Knickerbocker Dialysis Inc | Clinic/Center | 931 Bruckner Blvd, Bronx, NY 10459-4525 | 2019-06-06 |
| 1306404926 | Knickerbocker Dialysis Inc | Clinic/Center | 203 W Route 59, Nanuet, NY 10954-2218 | 2019-05-29 |
| Street Address |
3440 BOSTON RD |
| City | BRONX |
| State | NY |
| Zip Code | 10469-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670884 | Morris Park Rehabilitation and Nursing Center LLC | Skilled Nursing Facility | 1235 Pelham Parkway North, Bronx, NY 10469 | 2020-05-08 |
| 1437705720 | Wafaa Khoury | Behavioral Analyst | Important Steps,inc, 2447 Eastchester Road, Bronx, NY 10469 | 2019-08-13 |
| 1033775432 | Sally Mendoza | Licensed Practical Nurse | 2506 Woodhul Ave, Bronx, NY 10469 | 2019-05-13 |
| 1215495221 | Fasilat Ibrahim | Registered Nurse | 1117 Adee St, Bronx, NY 10469 | 2019-03-08 |
| 1467922096 | Patience Marku Kitcher | Registered Nurse | 954 East 211 Street, Bronx, NY 10469 | 2018-11-27 |
| 1316422546 | Leon Anibal Guzman | Registered Nurse | 3230 Paulding Ave 1fl, New York, NY 10469 | 2018-10-03 |
| 1205328358 | Yesenia A. Arias | Case Manager/Care Coordinator | 1501 Astor Ave., Suite 1a, Bronx, NY 10469 | 2018-06-05 |
| 1720578719 | Kimberly Carrion Alicea | Psychologist | 2323 Eastchester Rd #27, Bronx, NY 10469 | 2018-05-15 |
| 1235627993 | Kayon Donaldson | Nurse Practitioner | 2904 Yates Ave, Bronx, NY 10469 | 2018-04-27 |
| 1699280404 | Joyce Wallace | Specialist | 2825-2 Ely Avenue, Bronx, NY 10469 | 2017-12-04 |
| Find all providers in zip 10469 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 1902456742 | Knickerbocker Dialysis Inc | Clinic/Center | 34 Marconi St Ste 110, Bronx, NY 10461-2755 | 2019-09-13 |
| 1407415243 | Knickerbocker Dialysis Inc | Clinic/Center | 931 Bruckner Blvd, Bronx, NY 10459-4525 | 2019-06-06 |
| 1700353943 | New York Dialysis Services Inc | Clinic/Center | 1776 Eastchester Rd Ste 240, Bronx, NY 10461-2335 | 2018-10-25 |
| 1730676743 | Knickerbocker Dialysis Inc | Clinic/Center | 1820 E Tremont Ave, Bronx, NY 10460-3131 | 2018-04-16 |
| 1013410133 | Knickerbocker Dialysis Inc | Clinic/Center | 2190 Jerome Ave, Bronx, NY 10453-1815 | 2018-03-15 |
| 1063911659 | Knickerbocker Dialysis Inc | Clinic/Center | 1490 Macombs Rd, Bronx, NY 10452-2101 | 2018-02-08 |
| 1275032856 | Knickerbocker Dialysis Inc | Clinic/Center | 2554 White Plains Rd, Bronx, NY 10467-8141 | 2018-02-08 |
| 1962957993 | Knickerbocker Dialysis Inc | Clinic/Center | 2331 Eastchester Rd, Bronx, NY 10469-5910 | 2016-08-19 |
| 1033582283 | Usrc Pelham, LLC | Clinic/Center | 1225a Morris Park Ave, Bronx, NY 10461-1929 | 2015-11-10 |
| Find all providers in BRONX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.