CRD Associates LLC

Primary specialty

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

License

7003266R Issued in NY

Legal business name

CRD ASSOCIATES LLC

Practice address

11919 Graham CT
Flushing, NY 11354-1047

Phone

(718) 886-0700

NPI assigned

Mar 29, 2006

Last updated

May 29, 2008By 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

Jack Deutsch

Title

Administrator

Phone

(718) 886-0700

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cliffside Renal Dialysis Other name

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1245291418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 GRAHAM CT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541047",
            "telephone_number": "718-886-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 GRAHAM CT",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113541047",
            "telephone_number": "718-886-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRD ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "718-886-0700"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "7003226R",
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7003266R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02739302",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cliffside Renal Dialysis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Flushing, NY
• Providers in Flushing, 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 May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.