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General NPI Number Information
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NPI Number | 1902890189
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Entity Type | Organization
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Legal Business Name | RENAL CARE OF ROCKLAND, INC.
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 131 ROUTE 303
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City | VALLEY COTTAGE
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State | NY
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Zip | 10989-5900
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Country | US
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Telephone | 845-268-2777
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Fax | 845-258-7198
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Provider Business Mailing Address
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Address Line | 131 ROUTE 303
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City | VALLEY COTTAGE
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State | NY
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Zip | 10989-5900
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Country | US
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Telephone | 845-268-2777
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Fax | 845-258-7198
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ANDREW H MORIBER
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Credential |
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Telephone | 305-534-1905
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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 | 43350202R
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License Number State | NY
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