Healthcare Provider Details

I. General information

NPI: 1235138272
Provider Name (Legal Business Name): NEPHROLOGY ASSOCIATES OF WESTCHESTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 200N
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

19 BRADHURST AVE SUITE 200N
HAWTHORNE NY
10532-2140
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-7701
  • Fax: 914-345-0653
Mailing address:
  • Phone: 914-593-1606
  • Fax: 914-593-1790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateNY

VIII. Authorized Official

Name: STEPHEN ADLER
Title or Position: PARTNER
Credential: MD
Phone: 914-493-7701