Healthcare Provider Details

I. General information

NPI: 1972630283
Provider Name (Legal Business Name): PREMIER HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 BEACH 68TH ST DIALYSIS UNIT
ARVERNE NY
11692-1407
US

IV. Provider business mailing address

430 BEACH 68TH ST DIALYSIS UNIT
ARVERNE NY
11692-1407
US

V. Phone/Fax

Practice location:
  • Phone: 718-474-0357
  • Fax: 718-474-1948
Mailing address:
  • Phone: 718-474-0357
  • Fax: 718-474-1948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number7001287R
License Number StateNY

VIII. Authorized Official

Name: MRS. HELEN TENENBAUM SIEGER
Title or Position: CEO
Credential:
Phone: 718-796-8100