South Shore Dialysis Inc. - Bellmore

Primary specialty

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

License

2906202R Issued in NY

Legal business name

SOUTH SHORE DIALYSIS INC. - BELLMORE

Practice address

250 Pettit Ave
Bellmore, NY 11710-3657

Phone

(516) 679-3090

NPI assigned

Jun 14, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Corene Korba

Title

Billing Manager

Phone

(914) 644-9276

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

South Shore Dialysis Center Inc - Hempstead2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Shore Dialysis Center Inc. - Hempstead

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • South Hempstead, NY
  • NPI 1609815760
  NPD tax ID

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083657464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103657",
            "telephone_number": "516-679-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PETTIT AVE",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103657",
            "telephone_number": "516-679-3090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE DIALYSIS INC. - BELLMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KORBA",
        "authorized_official_first_name": "CORENE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-644-9276",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "2906202R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803892",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROISS",
            "identifier": "009261",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Staci Megan Smith, DMD
• Caroline May Smyth, NP
• Nathan Solat, O.D.
• William Solz
• South Nassau Primary Medical Care PC
• South Shore Smiles Orthodontics
• Samantha Speziale, DPT
• Tanya Spitznagel
• Fred Spivack, RPH
• Sports Physical Therapy Occupational Therapy and Rehabilitation Servic

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bellmore, NY
• Providers in Bellmore, 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 Jul 21, 2022; 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.