Vestal Healthcare LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

VESTAL HEALTHCARE LLC

Doing business as

Freedom Center of Queens

Practice address

17627 Union Tpke
Fresh Meadows, NY 11366-1515

Phone

(718) 969-3293

Fax

(718) 969-3927

NPI assigned

Feb 5, 2015

Organization subpart

Yes

Parent organization

FRESENIUS MEDICAL CARE HOLDINGS, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Caputo

Title

President

Phone

(206) 816-6505

Specialties & licenses 1

Addresses

Other names 1

• Freedom Center of Queens Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477526400000",
    "number": "1083005573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17627 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661515",
            "telephone_number": "718-969-3293",
            "fax_number": "718-969-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17627 UNION TPKE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661515",
            "telephone_number": "718-969-3293",
            "fax_number": "718-969-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VESTAL HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRESENIUS MEDICAL CARE HOLDINGS, INC.",
        "enumeration_date": "2015-02-05",
        "last_updated": "2016-10-27",
        "status": "A",
        "authorized_official_last_name": "CAPUTO",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-816-6505",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Freedom Center of Queens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vikas Varma, MD
• Stella Vazquez
• Anthony Vecchia, MD
• Paula Ventre, MA
• Venus Consulting and Medical Staffing LLC
• VI Fitness Inc
• Vibrant Women Wellness Counseling, LCSW, PLLC
• Maria Vicioso
• Mariely Vidal, BA
• Irene Villalba, CSW

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.