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NPI Code Detail

MEDICARE: BRONX CENTER FOR RENAL DIALYSIS LLC

MEDICARE: BRONX CENTER FOR RENAL DIALYSIS LLC
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1801434717
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRONX CENTER FOR RENAL DIALYSIS LLC
Provider Business Mailing Address
First Line : 4770 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10470-1104
Country : US
Telephone Number : 718-931-9700
Fax Number :
Provider Business Practice Location Address
First Line : 170 BUFFALO AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-2421
Country : US
Telephone Number : 718-931-9700
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : KENNETH ROZENBERG
Credential :
Telephone Number : 718-931-9700
Provider Enumeration Date : 12/11/2019
Last Update Date : 12/11/2019

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