MEDICARE: MIDWOOD CHAYIM ARUCHIM DIALYSIS ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	332598	OTHER	NY	MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740225408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWOOD CHAYIM ARUCHIM DIALYSIS ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	1915 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6801
Country	:	US
Telephone Number	:	718-258-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6801
Country	:	US
Telephone Number	:	718-258-7700
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MICHAEL SHTERN
Credential	:
Telephone Number	:	718-258-7700

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/30/2013

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