Knickerbocker Dialysis Inc

Primary specialty

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

Legal business name

KNICKERBOCKER DIALYSIS INC

Practice address

25217 Northern Blvd
Little Neck, NY 11362-1355

Phone

(718) 292-3598

Fax

(718) 292-3593

NPI assigned

Jun 28, 2018

Organization subpart

No

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

Authorized official

Name

James Hilger

Title

Chief Accounting Officer

Phone

(615) 320-4414

Specialties & licenses 1

Addresses

Other names 1

• Little Neck Dialysis Doing business as

Locations

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1174018329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L AND C DEPT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4414",
            "fax_number": "866-865-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25217 NORTHERN BLVD",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621355",
            "telephone_number": "718-292-3598",
            "fax_number": "718-292-3593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNICKERBOCKER DIALYSIS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "615-320-4414"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Neck Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Kim, DDS
• Kathy Kim, DMD
• Samuel Kim, LAC
• Sue Kim
• Kims Acupuncture Ny PC
• Hae Jung Ko, D.D.S.
• Gayle Hope Kolidas, LCSW
• Madison Lee Kolnsberg, ATC
• Kern Scott Koo, D.O.
• Anna M. Koskinas

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Little Neck, NY
• Providers in Little Neck, 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 Jun 28, 2018; 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.