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General NPI Number Information
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NPI Number | 1972442473
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Entity Type | Organization
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Legal Business Name | BRONX RENAL SERVICES
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 4451 3RD AVE
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City | BRONX
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State | NY
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Zip | 10457-2567
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Country | US
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Telephone | 718-960-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 4451 3RD AVE
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City | BRONX
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State | NY
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Zip | 10457-2567
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Country | US
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Telephone | 718-960-3860
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MILES DAVIS
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Credential |
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Telephone | 917-731-6684
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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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