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General NPI Number Information
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NPI Number | 1982340303
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Entity Type | Organization
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Legal Business Name | STAR CARE DIALYSIS
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 55 CARLETON AVE
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City | EAST ISLIP
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State | NY
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Zip | 11730-2133
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Country | US
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Telephone | 631-803-6008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 933
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City | BELLPORT
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State | NY
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Zip | 11713-0933
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Country | US
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Telephone | 631-803-6008
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR OF EDUCATION
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Name | SHEILA MARY DONAGHY
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Credential | RN, BSN, MBA
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Telephone | 631-803-6008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2472R0900X
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Taxonomy Name | Renal Dialysis Technician
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License Number |
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License Number State |
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