Newark Renal Centers, LLC

Primary specialty

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

License

40704 Issued in NJ

Legal business name

NEWARK RENAL CENTERS, LLC

Practice address

580 Frelinghuysen Ave
Newark, NJ 07114-1324

Phone

(973) 624-2226

Fax

(973) 624-5547

NPI assigned

Jan 19, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Vicki L Burrier, RN, MBA

Title

Director/Vice-President

Phone

(954) 474-7701

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Parkside Dialysis Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Anthony Grasso, MD

  • Nephrology Physician
  • West Orange, NJ
  • NPI 1821063785
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104806785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7061 CYPRESS RD",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172243",
            "telephone_number": "954-474-7701",
            "fax_number": "954-474-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 FRELINGHUYSEN AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071141324",
            "telephone_number": "973-624-2226",
            "fax_number": "973-624-5547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWARK RENAL CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURRIER",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/VICE-PRESIDENT",
        "authorized_official_telephone_number": "954-474-7701",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NJ",
            "license": "40704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4143809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Newark Public Schools
• Newark Rehabilitation Center PA
• Newark Renaissance House, Inc
• Newark Renaissance House, Inc
• Newark Renaissance House, Inc
• Newark Vein and Vascular Center LLC
• Newly Destined, Inc.
• Brian Keith Newsome
• Nextpath Support Services LLC
• Praise Nformi, MD

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Newark, NJ
• Providers in Newark, NJ by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.