Organization · Type 2 NPI

Knickerbocker Dialysis Inc

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

NPI number 1679148084 Active

Practice location

700 Old Country Rd, Ste 4
Riverhead, NY 11901-2129

Call (631) 208-0282 Map

Fax (631) 208-0129

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...

2 other providers at this address

East End Respiratory Therapy PCCertified Respiratory Therapist Riverhead, NY NPI 1205406881
True North Vi DC LLCEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center Riverhead, NY NPI 1114738358

Other end-stage renal disease (esrd) treatment clinic/center providers in Riverhead

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NPI record

NPI: 1679148084
Entity type: Organization (Type 2)
Issued: May 26, 2021
Last updated: Dec 29, 2023
Status: Active

Other names

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Peconic Bay Dialysis · doing business as
Peconic Bay Dialysis · doing business as

Authorized official

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

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1679148084

Knickerbocker Dialysis Inc's National Provider Identifier is 1679148084, issued on May 26, 2021. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Riverhead, NY. The record was last updated on Dec 29, 2023.