Organization Active NPI

South Queens Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Jamaica, NY
National Provider Identifier
1205957446
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SOUTH QUEENS DIALYSIS CENTER
Practice address
17537 Liberty Ave
Jamaica, NY 11433-1325
Phone
(718) 297-9100
Fax
(718) 297-0625
NPI assigned
Apr 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Authorized official

Name
Dr. Robert Slifkin, M.D.
Title
Owner
Phone
(516) 626-8947

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

17537 Liberty Ave
Jamaica, NY 11433-1325

Mailing address

17537 Liberty Ave
Jamaica, NY 11433-1325
Phone (718) 297-9100

Other names 1

  • South Queens Dialysis Center Doing business as

National Provider Directory

National Provider Directory

Locations

17537 Liberty Ave
Jamaica, NY 11433
Phone (718) 207-9100

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253145600000",
    "number": "1205957446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17537 LIBERTY AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114331325",
            "telephone_number": "718-297-9100",
            "fax_number": "718-297-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17537 LIBERTY AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114331325",
            "telephone_number": "718-297-9100",
            "fax_number": "718-297-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH QUEENS DIALYSIS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2009-09-17",
        "status": "A",
        "authorized_official_last_name": "SLIFKIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-626-8947",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": "South Queens Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; 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.