Rockaway Kidney Center LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ROCKAWAY KIDNEY CENTER LLC

Practice address

529 Beach 20TH St
Far Rockaway, NY 11691-3645

Phone

(516) 770-5712

Fax

(718) 228-8036

NPI assigned

Jul 27, 2016

Organization subpart

No

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

Authorized official

Name

Olusegun Ogunfowora, MD

Title

MD

Phone

(516) 770-5712

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1669925533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913645",
            "telephone_number": "516-770-5712",
            "fax_number": "718-228-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913645",
            "telephone_number": "516-770-5712",
            "fax_number": "718-228-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKAWAY KIDNEY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "OGUNFOWORA",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "516-770-5712",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rockaway Adult Social Center
• Rockaway Care Center LLC
• Rockaway HD LLC
• Rockaway Home Attendant Services, Inc
• Rockaway Home Attendant Services, Inc.
• Rockaway Operations Associates LLC
• Rockaway Physician PLLC
• Rockaway Vendor Housekeeping Services, Inc.
• Golda Rockove, MSW
• Diana Patricia Rodriguez, PA-C

• Medical Specialty Clinic/Center in Far Rockaway, NY
• Providers in Far Rockaway, NY by specialty
• Medical Specialty Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.