GREEN MANOR DIALYSIS CENTER LLC (NPI# 1760836126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760836126 |
| Entity Type | Organization |
| Organization Name | GREEN MANOR DIALYSIS CENTER LLC |
| Other Organization Name | EAST GREENBUSH DIALYSIS |
| Practice Address |
583 Columbia Tpke East Greenbush NY 12061-1602 |
| Practice Telephone | 5184774370 |
| Practice Fax Number | 5184774319 |
| Mailing Telephone | 5184774370 |
| Mailing Fax Number | 5184774319 |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | EDWARD FOURNIER (DIRECTOR OF DIALYSIS SERVICES) |
| Authorized Official Telephone | 5188280717 |
| Authorized Official Credential | RN,CNN |
| 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 |
1059202R | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01687094 | 05 |
| Other Name | Type Code |
|---|---|
| East Greenbush Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912991266 | Green Manor Dialysis Center LLC | Clinic/Center | 159 Jefferson Hts, Catskill, NY 12414-1237 | 2005-09-01 |
| 1467445601 | Green Manor Dialysis Center LLC | Clinic/Center | 30 Whittier Way, Ghent, NY 12075 | 2005-08-23 |
| Street Address |
583 COLUMBIA TPKE |
| City | EAST GREENBUSH |
| State | NY |
| Zip Code | 12061-1602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215464987 | Dialysis Clinic Inc | Clinic/Center | 583 Columbia Tpke, East Greenbush, NY 12061-1602 | 2017-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285096040 | Anne Keetz Redmond | Specialist | 673 Columbia Turnpike, Capital District Beginnings, East Greenbush, NY 12061 | 2016-03-22 |
| 1649523010 | James Mcdermott | Counselor | 743 Columbia Turnpike, East Greenbush, NY 12061 | 2012-10-22 |
| 1851606222 | Caley S Barile | Dentist | 114 Troy Road, East Greenbush, NY 12061 | 2010-08-10 |
| 1932334489 | Kathleen Kern Saunders | Social Worker | 22 Bri Lan Ave., East Greenbush, NY 12061 | 2009-05-27 |
| 1326148313 | Richard D Shade Jr. | Chiropractor | 569 Columbia Turnpike, East Greenbush, NY 12061 | 2006-09-22 |
| 1831207257 | Rensselaer Planning LLC | Assisted Living Facility | 1070 Luther Road, East Greenbush, NY 12061 | 2006-08-26 |
| 1891759296 | Kanchan P Singh | Optometrist | 609 Columbia Turnpike, Empire Vision Centers, East Greenbush, NY 12061 | 2006-04-13 |
| 1245706613 | East Greenbush Chiropractic Pllc | Chiropractor | 569 Columbia Turnpike, East Greenbush, NY 12061 | 2018-10-23 |
| 1639645419 | East Greenbush Chiropractic Pllc | Chiropractor | 569 Columbia Turnpike, East Greenbush, NY 12061 | 2018-10-18 |
| 1508385436 | Cara Della Villa | Specialist | 673 Columbia Turnpike, East Greenbush, NY 12061 | 2017-09-12 |
| Find all providers in zip 12061 | ||||
| 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 |
|---|---|---|---|---|
| 1215464987 | Dialysis Clinic Inc | Clinic/Center | 583 Columbia Tpke, East Greenbush, NY 12061-1602 | 2017-05-12 |
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|---|---|---|---|---|
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| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 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 |
| 1225667819 | New York Dialysis Services, Inc | Clinic/Center | 1 East Jericho Turnpike, Mineola, NY 11501 | 2020-04-06 |
| 1205461639 | Knickerbocker Dialysis Inc | Clinic/Center | 1277 Middle Country Rd, Middle Island, NY 11953 | 2020-03-05 |
| 1326678111 | New York Dialysis Services, Inc | Clinic/Center | 794 St Anns Ave, Bronx, NY 10456 | 2020-01-21 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | EAST GREENBUSH |
| Zip Code | 12061 |
Please comment or provide details below to improve the information on GREEN MANOR DIALYSIS CENTER LLC.
| 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.