Liberty RC Inc

Primary specialty

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

License

1401232R Issued in NY

Legal business name

LIBERTY RC INC

Doing business as

Bedford Park Dialysis Center

Practice address

3117 Webster Ave
FL 1
Bronx, NY 10467-4905

Phone

(718) 920-1530

Fax

(718) 920-1520

NPI assigned

May 15, 2007

Last updated

Aug 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John D Winstel

Title

Chief Accounting Officer

Phone

(253) 733-4501

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bedford Park Dialysis Center Doing business as

Locations

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1154537132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L & C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-341-6410",
            "fax_number": "888-662-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 WEBSTER AVE",
            "address_2": "FL 1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104674905",
            "telephone_number": "718-920-1530",
            "fax_number": "718-920-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY RC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "WINSTEL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-733-4501"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "1401232R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03060428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bedford Park Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bedford Park Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aida Libasci
• Charles Edmond Libby, MD
• Olivia Liberatore
• Rasheena Monique Libert'E
• Liberty RC Inc (Eastchester Road Dialysis Center)
• Liberty RC Inc (Mount Hope Dialysis)
• Liberty Rhea Ranada Ebarle PT PC
• Atara Libman, MS, OTR/L
• Anastasia Libovich, LM
• Libra Suites

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bronx, NY
• Providers in Bronx, 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 Aug 3, 2023; 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.