KNICKERBOCKER DIALYSIS INC (NPI# 1679192876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679192876 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Practice Address |
1734 Hancock St Ridgewood NJ 11385-4734 |
| Mailing Address |
5200 Virginia Way L and C Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9292901267 |
| Practice Fax Number | 9179095950 |
| Mailing Telephone | 6153204414 |
| Mailing Fax Number | 8668652884 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 6153204414 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAVITA INC |
| 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 |
|---|---|
| Ridge Care 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 |
| 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 |
| 1487133633 | Knickerbocker Dialysis Inc | Clinic/Center | 54 New Lots Ave, Brooklyn, NY 11212-6934 | 2018-08-08 |
| Street Address |
1734 HANCOCK ST |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 11385-4734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326650425 | Nicole Jablonska | Speech-Language Pathologist | 60-24 Grove Street, Ridgewood, NY 11385 | 2020-08-19 |
| 1295393296 | Ila Debra Christmas | Clinic/Center | 67-29 Myrtle Avenue, Glendale, NY 11385 | 2019-06-04 |
| 1164929584 | Carmen E. Vidal | Case Manager/Care Coordinator | 61-06 Metropolitan Ave., Ridgewood, NY 11385 | 2018-04-11 |
| 1467955385 | Avchemists LLC | Pharmacy | 68-28 Myrtle Ave, Glendale, NY 11385 | 2018-03-16 |
| 1235639667 | Yu-jen Hwang | Physical Therapist | 55-05 Myrtle Avenue, 2nd Floor, Ridgewood, NY 11385 | 2018-02-12 |
| 1477069185 | Selena Delgado | Behavior Technician | 64-07 Cooper Avenue, Glendale, NY 11385 | 2017-12-18 |
| 1851806913 | Myrtle Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 7933 Myrtle Ave, Flushing, NY 11385 | 2017-12-11 |
| 1104345727 | Suzanne Eng | Counselor | 1080 Wykoff Ave., Suite D4, Ridgewood, NY 11385 | 2017-09-14 |
| 1588183339 | Geri P Services Inc. | Early Intervention Provider Agency | 5938 Gates Ave, Ridgewood, NY 11385 | 2017-09-13 |
| 1922523935 | Kristen Michele Spang | Speech-Language Pathologist | 79-56 77th Road, Glendale, NY 11385 | 2017-08-10 |
| Find all providers in zip 11385 | ||||
| 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 |
|---|---|---|---|---|
| 1467451229 | Ridgewood Dialysis Center, Inc | Clinic/Center | 385 Seneca Ave, Ridgewood, NY 11385-1340 | 2005-07-14 |
| 1831430990 | New York Renal Physicians Ipa, LLC | Clinic/Center | 385 Seneca Ave, Ridgewood, NY 11385-1340 | 2013-03-13 |
| 1003892332 | The Valley Hospital Inc. | Clinic/Center | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356963938 | Usrc Gloucester, LLC | Clinic/Center | 601 Berlin Cross Keys Rd, Sicklerville, NJ 08081-9563 | 2020-05-18 |
| 1750910295 | Elandon Dialysis LLC | Clinic/Center | 820 N Rte 17, Paramus, NJ 07652-3104 | 2020-04-06 |
| 1780212365 | Zellier Dialysis LLC | Clinic/Center | 1260 Route 22 E, North Plainfield, NJ 07060 | 2020-03-30 |
| 1437798386 | Total Renal Care Inc | Clinic/Center | 1800 State Route 34 Ste 302, Wall Township, NJ 07719-9146 | 2019-12-24 |
| 1598306276 | Fresenius Medical Care Passaic, LLC | Clinic/Center | 10 Clifton Blvd Ste 1, Clifton, NJ 07011-3802 | 2019-10-03 |
| 1821646035 | Isd Renal Inc | Clinic/Center | 262 Broad St, Newark, NJ 07104-3809 | 2019-08-30 |
| 1699323824 | Claymount Dialysis LLC | Clinic/Center | 21 Cornwell Dr, Bridgeton, NJ 08302-3632 | 2019-08-30 |
| 1962064758 | Fresenius Medical Care Bridgeton, LLC | Clinic/Center | 12 Cornwell Dr, Bridgeton, NJ 08302-3633 | 2019-07-02 |
| 1790347698 | Wellbound of Cherry Hill, LLC | Clinic/Center | 1945 Route 70 E Ste A, Cherry Hill, NJ 08003-2117 | 2019-07-01 |
| 1033770458 | Pinson Dialysis LLC | Clinic/Center | 547 Morris Ave, Elizabeth, NJ 07208-1985 | 2019-06-26 |
| Find all providers with the same taxonomy | ||||
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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.