Organization · Type 2 NPI

Knickerbocker Dialysis Inc

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

NPI number 1679192876 Active

Practice location

1734 Hancock St
Ridgewood, NY 11385-4734

Call (929) 290-1267 Map

Fax (917) 909-5950

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...

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NPI record

NPI: 1679192876
Entity type: Organization (Type 2)
Issued: Apr 9, 2020
Last updated: Jun 2, 2026
Status: Active

Other names

<unavail>
Ridge Care Dialysis · doing business as
Ridge Care Dialysis · doing business as

Authorized official

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

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About NPI 1679192876

Knickerbocker Dialysis Inc's National Provider Identifier is 1679192876, issued on Apr 9, 2020. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Ridgewood, NY. The record was last updated on Jun 2, 2026.