Healthcare Provider Details

I. General information

NPI: 1619037520
Provider Name (Legal Business Name): RENAL CARE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 N CENTRE AVE #300
ROCKVILLE CENTRE NY
11570-3923
US

IV. Provider business mailing address

77 N CENTRE AVE #300
ROCKVILLE CENTRE NY
11570-3923
US

V. Phone/Fax

Practice location:
  • Phone: 516-764-5807
  • Fax: 516-764-5808
Mailing address:
  • Phone: 516-764-5807
  • Fax: 516-764-5808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL FRIEDMANN
Title or Position: PRESIDENT
Credential: MD
Phone: 516-764-5807