Healthcare Provider Details

I. General information

NPI: 1083734412
Provider Name (Legal Business Name): NEW YORK DIALYSIS SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

1000 SOUTH AVE
ROCHESTER NY
14620-2733
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-8201
  • Fax: 585-341-8352
Mailing address:
  • Phone: 585-341-8201
  • Fax: 585-341-8352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. NATHAN LEVIN
Title or Position: OWNER AND OPERATOR
Credential: M.D.
Phone: 212-360-4944