| Cliffside Renal Dialysis | |
|
11919 Graham Ct Flushing NY 11354-1047 | |
| (718) 886-0700 | |
| Not Available |
| Full Name | Cliffside Renal Dialysis |
|---|---|
| Speciality | Clinic/Center |
| Location | 11919 Graham Ct, Flushing, New York |
| Authorized Official Name and Position | Jack Deutsch (ADMINISTRATOR) |
| Authorized Official Contact | 7188860700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cliffside Renal Dialysis 11919 Graham Ct Flushing NY 11354-1047 Ph: (718) 886-0700 | Cliffside Renal Dialysis 11919 Graham Ct Flushing NY 11354-1047 Ph: (718) 886-0700 |
| NPI Number | 1245291418 |
|---|---|
| Provider Enumeration Date | 03/29/2006 |
| Last Update Date | 05/29/2008 |
| Medicare PECOS PAC ID | 3072553296 |
|---|---|
| Medicare Enrollment ID | O20050506000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245291418 | NPI | - | NPPES |
| 02739302 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 7003226R (New York) | Secondary |
| 261QE0700X | Clinic/center - End-stage Renal Disease (esrd) Treatment | 7003266R (New York) | Primary |
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