Western Queens Dialysis

Primary specialty

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

License

7001256A Issued in NY

Legal business name

WESTERN QUEENS DIALYSIS

Practice address

3401 35TH Ave
Astoria, NY 11106-1222

Phone

(718) 707-9988

Fax

(718) 707-9830

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Jeff Gurkin

Title

VP - Remibursement

Phone

(347) 312-3034

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639212939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 COLLEGE POINT BLVD",
            "city": "COLLEGE POINT",
            "state": "NY",
            "postal_code": "113562526",
            "telephone_number": "347-312-3034",
            "fax_number": "347-312-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 35TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111061222",
            "telephone_number": "718-707-9988",
            "fax_number": "718-707-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN QUEENS DIALYSIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GURKIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "VP - REMIBURSEMENT",
        "authorized_official_telephone_number": "347-312-3034"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NY",
            "license": "7001256A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167953",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wellness Center Pharmacy Inc
• Wellness Center Psychologist Adriana L Gonzalez PHD PLLC
• Wellness Medical Doctor P.C.
• John S Wen
• Meghan E. Wendelken
• Amybeth Whissel, NBHWC
• Arielle J White
• Stephanie White, SLP
• Diane Wiener, SLP
• Adama Wiggan

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Astoria, NY
• Providers in Astoria, 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.