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General NPI Number Information
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NPI Number | 1568695765
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Entity Type | Organization
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Legal Business Name | KIDNEY AND HYPERTENSION MEDICINE, P.C.
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 09/03/2009
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Provider Practice Location Address
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Address Line | 4143 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5637
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Country | US
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Telephone | 917-797-3170
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Fax |
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Provider Business Mailing Address
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Address Line | 4143 RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5637
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Country | US
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Telephone | 917-797-3170
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RON CHAY
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Credential | M.D.
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Telephone | 917-797-3170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 240901
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License Number State | NY
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