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

South Brooklyn Nephrology Center

Practice address

3915 Avenue V
Ste 104
Brooklyn, NY 11234-5156

Phone

(718) 252-8440

Fax

(718) 252-6490

NPI assigned

Dec 9, 2009

Last updated

Dec 19, 2024By 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

Samuel Wey

Title

Assistant Secretary

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Brooklyn Nephrology Center Doing business as

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1578892261",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 AVENUE V",
            "address_2": "STE 104",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345156",
            "telephone_number": "718-252-8440",
            "fax_number": "718-252-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY RC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "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": "00698095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Brooklyn Nephrology Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Brooklyn Nephrology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Liberty Medical, LLC
• Liberty Medicine & Rehab PC
• Liberty Medicine & Rehab.
• Liberty Mobile Testing Inc
• Liberty RC Inc (Dyker Heights Dialysis Center)
• Liberty Social Adult Daycare Inc
• Jenny M. Libien, M.D.
• Liana Libin, DDS
• Alla Libman, MSW
• Lauren M Libman, PHARM. D

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, 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 Dec 19, 2024; 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.