KNICKERBOCKER DIALYSIS INC NPI 1770027294

NPI Information

  • NPI: 1770027294
  • Provider Name: KNICKERBOCKER DIALYSIS INC
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Doing Business As: BROOKLYN COMMUNITY DIALYSIS
  • Address: 730 64TH ST
    BROOKLYN, NY
    ZIP 11220
  • Phone: (718) 759-0129

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NPI Details

KNICKERBOCKER DIALYSIS INC is an end-stage renal disease (esrd) treatment clinic center in Brooklyn, NY. KNICKERBOCKER DIALYSIS INC NPI is 1770027294. The provider is registered as an organization entity type.
The provider Is Doing Business As Brooklyn Community Dialysis.

The provider's business location address is:

730 64TH ST
BROOKLYN, NY
ZIP 11220-714
Phone: (718) 759-0129
Fax: (718) 759-0191

The provider's authorized official is John D Winstel .
The authorized official title is Chief Accounting Officer and has the following contact phone number (253) 733-4501.

The enumeration date for this NPI number is 12/19/2016 and was last updated on 3/3/2021.

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
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment7000272RNEW YORKYes

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
105400871MEDICAIDNEW YORK

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: 3/30/2025

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