KNICKERBOCKER DIALYSIS INC (NPI# 1467489369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467489369 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | BOSTON POST ROAD DIALYSIS CENTER |
| Practice Address |
4026 Boston Rd Bronx NY 10475-1122 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7188629245 |
| Practice Fax Number | 7188629238 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-04-15 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER, TREASURER) |
| Authorized Official Telephone | 2537334500 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03048588 | 05 |
| Other Name | Type Code |
|---|---|
| Boston Post Road Dialysis Center | 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 |
4026 BOSTON RD |
| City | BRONX |
| State | NY |
| Zip Code | 10475-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973048 | Sharon Antoinette Hall | Registered Nurse | 2552 Pelham Bay Park West, Apt 1 D, 2551 Pelham Bay Park West, Bronx, NY 10475 | 2019-07-11 |
| 1265912042 | Bartow Pharmacy Inc. | Pharmacy | 500-5 Baychester Ave. Store #5, Bronx, NY 10475 | 2018-08-21 |
| 1518465996 | Jacqueline Caraballo | Nurse Practitioner | 100 De Kruif Place Apt 27h, Bronx, NY 10475 | 2018-01-31 |
| 1093227142 | Rachel Obeng Mireku | Licensed Practical Nurse | 140 Dekruif Place, Apt # 26k, Bronx, NY 10475 | 2017-10-30 |
| 1023534518 | Nelson Merritt Hall | Chiropractor | 2100 Bartow Ave, Ste #227, Bronx, NY 10475 | 2017-08-17 |
| 1245769363 | Sharon Holland Johnson | Licensed Practical Nurse | 140 Dekruif Pl, Bronx, NY 10475 | 2017-06-12 |
| 1740719152 | Nadia S Etienne | Licensed Practical Nurse | 120 De Kruif Place, Apt 18h, Bronx, NY 10475 | 2017-06-08 |
| 1407385891 | Ashley N Freeze | Case Manager/Care Coordinator | 140 Darrow Place Suite 24e, Bronx, NY 10475 | 2017-06-08 |
| 1912454091 | Usth.inc | Early Intervention Provider Agency | 120 Coop City Blvd, 21-f, Bronx, NY 10475 | 2016-09-06 |
| 1447626130 | Zelda Boomer | Registered Nurse | 920 Coop City Blvd Bx. Ny 10475, Bronx, NY 10475 | 2015-08-17 |
| Find all providers in zip 10475 | ||||
| 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 |
| 1063932945 | Knickerbocker Dialysis Inc | Clinic/Center | 3440 Boston Rd, Bronx, NY 10469-2512 | 2017-06-22 |
| 1962957993 | Knickerbocker Dialysis Inc | Clinic/Center | 2331 Eastchester Rd, Bronx, NY 10469-5910 | 2016-08-19 |
| 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.