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General NPI Number Information
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NPI Number | 1134665805
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Entity Type | Organization
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Legal Business Name | ALARIS HEALTH DIALYSIS AT ESSEX LLC
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 155 40TH ST
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City | IRVINGTON
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State | NJ
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Zip | 07111-1184
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Country | US
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Telephone | 201-216-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 35 JOURNAL SQ 1103
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City | JERSEY CITY
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State | NJ
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Zip | 07306-4007
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Country | US
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Telephone | 201-216-9500
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Fax | 201-216-9656
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Authorized Official
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Title or Position | OWNER
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Name | AVERY EISENREICH
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Credential |
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Telephone | 201-216-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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