South Shore Dialysis Center Inc. - Hempstead

Primary specialty

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

License

2906202R Issued in NY

Legal business name

SOUTH SHORE DIALYSIS CENTER INC. - HEMPSTEAD

Practice address

160 N Franklin St
South Hempstead, NY 11550-1317

Phone

(516) 483-6702

NPI assigned

Jun 5, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Corene Korba

Title

Billing Manager

Phone

(914) 644-9276

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

South Shore Dialysis Center Inc - Hempstead2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• South Shore Dialysis Inc. - Bellmore

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Bellmore, NY
  • NPI 1083657464
  NPD tax ID

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609815760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 N FRANKLIN ST",
            "city": "SOUTH HEMPSTEAD",
            "state": "NY",
            "postal_code": "115501317",
            "telephone_number": "516-483-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N FRANKLIN ST",
            "city": "SOUTH HEMPSTEAD",
            "state": "NY",
            "postal_code": "115501317",
            "telephone_number": "516-483-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE DIALYSIS CENTER INC. - HEMPSTEAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KORBA",
        "authorized_official_first_name": "CORENE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "914-644-9276",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "2906202R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803892",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "005317",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Gabriela Moronta
• Paul Mwaura Njuguna, LPN
• Nikita Nunn
• Shari Richardson, LCSW
• Devon Michael Sam, CNA, EMT
• Roseann J Spatz, AU.D.
• Talking Mindz, Inc.
• Benche Tan

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Hempstead, NY
• Providers in South Hempstead, 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 22, 2020; 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.