NEWARK RENAL CENTERS LLC NPI 1104806785

NPI Information

NPI: 1104806785
Provider Name: NEWARK RENAL CENTERS, LLC

Doing Business As: PARKSIDE DIALYSIS CENTER

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

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
580 FRELINGHUYSEN AVE
NEWARK, NJ
ZIP 07114
Phone: (973) 624-2226
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NEWARK RENAL CENTERS, LLC is an end-stage renal disease (esrd) treatment clinic center in Newark, NJ. NEWARK RENAL CENTERS, LLC NPI is 1104806785. The provider is registered as an organization entity type.
The provider Is Doing Business As Parkside Dialysis Center.

The provider's business location address is:

580 FRELINGHUYSEN AVE
NEWARK, NJ
ZIP 07114-324
Phone: (973) 624-2226
Fax: (973) 624-5547

The provider's authorized official is Vicki L Burrier .
The authorized official title is Director/vice-president and has the following contact phone number (954) 474-7701.

The CLIA number assigned to this NPI record is 31D0938869 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/19/2006 and was last updated on 8/22/2020.

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	40704	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	4143809	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

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