Healthcare Provider Details

I. General information

NPI: 1598746257
Provider Name (Legal Business Name): CHINATOWN DIALYSIS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 HESTER ST SECOND FLOOR
NEW YORK NY
10013
US

IV. Provider business mailing address

213 HESTER ST SECOND FLOOR
NEW YORK NY
10013-4966
US

V. Phone/Fax

Practice location:
  • Phone: 212-925-0404
  • Fax: 212-725-3538
Mailing address:
  • Phone: 212-925-0404
  • Fax: 212-725-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number7002171R
License Number StateNY

VIII. Authorized Official

Name: MRS. MIRIAM SINITZKY
Title or Position: CHIEF OPERATING OFFICER
Credential: CPA
Phone: 212-889-0770