MEDICARE: DIALYSIS CLINIC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	7004207R	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518990993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIALYSIS CLINIC INC.

Provider Business Mailing Address
First Line	:	1550 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1578
Country	:	US
Telephone Number	:	718-816-6455
Fax Number	:	718-816-5460

Provider Business Practice Location Address
First Line	:	1550 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-1578
Country	:	US
Telephone Number	:	718-983-7000
Fax Number	:	718-370-9543

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DONOVAN SCHULTZ
Credential	:
Telephone Number	:	615-327-3061

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	10/04/2023

Similar Medicare Providers

1710989470 — DR. JEFFREY DAVID SCHILLER M.D.
Practice Location Address:

1550 RICHMOND AVE , SUITE 208
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-370-1001
Practice Fax: 718-370-0945

1720190259 — CARL G SCEUSA MD
Practice Location Address:

1550 RICHMOND AVE , SUITE 202
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-370-7700
Practice Fax: 718-370-7798

1891887543 — MRS. PATRICIA C MCCORMACK M.D.
Practice Location Address:

1550 RICHMOND AVE
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-698-9572
Practice Fax: 718-698-9573

1972757672 — JOHN M PEPE MD PLLC
Practice Location Address:

1550 RICHMOND AVE
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-982-7800
Practice Fax:

1336381136 — LISA ANN SHEA PA-C
Practice Location Address:

1550 RICHMOND AVE , SUITE 207
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-698-1616
Practice Fax: 718-698-9573

1891097242 — DR. CARL SCEUSA M.D. AND DR. JAMES LAMIA M.D.
Practice Location Address:

1550 RICHMOND AVE , SUITE 202
STATEN ISLAND, NY
10314-1578

Practice Phone: 718-370-7700
Practice Fax: 718-370-7798

Directions to “DIALYSIS CLINIC INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.