Organization · Type 2 NPI

Knickerbocker Dialysis Inc

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Garden City, NY

NPI number 1083640270 Active

Practice location

1100 Stewart Ave, Ste 2
Garden City, NY 11530-4839

Call (516) 357-0004 Map

Fax (516) 357-7377

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

NPI record

NPI: 1083640270
Entity type: Organization (Type 2)
Issued: Jun 23, 2006
Last updated: Feb 16, 2026
Status: Active

Other names

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Garden City Dialysis Center · doing business as
Garden City Dialysis Center · doing business as

Authorized official

Samuel T Wey
VP Licensure & Certification
(615) 341-6641

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About NPI 1083640270

Knickerbocker Dialysis Inc's National Provider Identifier is 1083640270, issued on Jun 23, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Garden City, NY. The record was last updated on Feb 16, 2026.