TYLER DIALYSIS LLC NPI 1154789659

NPI Information

NPI: 1154789659
Provider Name: TYLER DIALYSIS LLC

Doing Business As: BROOKLAWN DIALYSIS

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
700 CRESCENT BLVD
STE 10B
BROOKLAWN, NJ
ZIP 08030
Phone: (856) 456-1230
Get Directions

TYLER DIALYSIS LLC is an end-stage renal disease (esrd) treatment clinic center in Brooklawn, NJ. TYLER DIALYSIS LLC NPI is 1154789659. The provider is registered as an organization entity type.
The provider Is Doing Business As Brooklawn Dialysis.

The provider's business location address is:

700 CRESCENT BLVD
STE 10B
BROOKLAWN, NJ
ZIP 08030-797
Phone: (856) 456-1230
Fax: (856) 742-7094

The provider's authorized official is Samuel T Wey .
The authorized official title is Sr Director Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 31D2129870 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2016 and was last updated on 9/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	24993	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0610666	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »