KNICKERBOCKER DIALYSIS INC (NPI# 1932135571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932135571 |
| Entity Type | Organization |
| Organization Name | KNICKERBOCKER DIALYSIS INC |
| Other Organization Name | SOUTH BRONX DIALYSIS CENTER |
| Practice Address |
1940 Webster Ave Ste 100 Bronx NY 10457-4261 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 7187163999 |
| Practice Fax Number | 7185837335 |
| Mailing Telephone | 6153416410 |
| Mailing Fax Number | 8886628259 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | JOHN D WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| 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 | 03048597 | 05 |
| Other Name | Type Code |
|---|---|
| South Bronx 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 |
1940 WEBSTER AVE STE 100 |
| City | BRONX |
| State | NY |
| Zip Code | 10457-4261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326498205 | Liberty Rc Inc | Clinic/Center | 1940 Webster Ave, 2nd Floor, Bronx, NY 10457-4261 | 2016-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851722 | Aruna Muthumanickam | Student in an Organized Health Care Education/Training Program | 1650 Grand Concourse, The Bronx, New York City, NY 10457 | 2020-08-11 |
| 1013527753 | Cherine Awad | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue, Bronxcare Health System, Bronx, NY 10457 | 2020-08-07 |
| 1023626926 | Tolulope Oyinlola Olorunsogo | Student in an Organized Health Care Education/Training Program | 1650 Selwyn Avenue - Bronxcare Health System, Departmen, Suite 6h, Bronx, NY 10457 | 2020-07-16 |
| 1750999801 | Kalyan C Chilukuri | Student in an Organized Health Care Education/Training Program | Bronxcare Hospital Center, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-15 |
| 1003434457 | Nauri Estefani Abreu Roa | Student in an Organized Health Care Education/Training Program | Bronxlebanon Health System, 1650 Grand Concourse, Bronx, NY 10457 | 2020-07-13 |
| 1033737630 | Sapna Sharma | Student in an Organized Health Care Education/Training Program | St. Barnabas Hospital, 4422 Third Avenue Bronx, Bronx, NY 10457 | 2020-07-09 |
| 1194341081 | Asha Tadepalli | Optometrist | 1650 Selwyn Avenue, Suite 1c, Bronxcare Health System, Department of Ophthalmology, Bronx, NY 10457 | 2020-06-17 |
| 1578196549 | Ernesto Murray | Technician | 463 East 178st Apt#3b, Bronx New York, NY 10457 | 2020-02-19 |
| 1245891001 | Muhammad Shahzad | Student in an Organized Health Care Education/Training Program | St. Barnabas Health 4422 Third Avenue, Bronx, NY 10457 | 2019-06-24 |
| 1144886565 | Grant Joseph Gleason | Student in an Organized Health Care Education/Training Program | 4422 3rd Avenue St Barbabas Hospital Dept of Dentistry, Bronx, NY 10457 | 2019-05-10 |
| Find all providers in zip 10457 | ||||
| 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.