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General NPI Number Information
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NPI Number | 1952382582
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Entity Type | Organization
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Legal Business Name | EASTVIEW DIALYSIS, INC.
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 120 VICTOR HEIGHTS PKWY
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City | VICTOR
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State | NY
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Zip | 14564-8934
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Country | US
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Telephone | 585-742-1250
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Fax | 585-472-1951
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Provider Business Mailing Address
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Address Line | 120 VICTOR HEIGHTS PKWY
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City | VICTOR
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State | NY
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Zip | 14564-8934
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Country | US
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Telephone | 585-742-1250
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Fax | 585-472-1951
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LORI SPALDING
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Credential |
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Telephone | 585-742-1250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OP. CERT.# 3464201R
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License Number State | NY
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