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

Last updated

Jul 27, 2016By 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

Olusegun Ogunfowora, MDNPI 1275602963

Title

MD

Phone

(516) 770-5712

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olusegun Ogunfowora, MD

  • Internal Medicine Physician
  • Far Rockaway, NY
  • NPI 1275602963
  Authorized official Same address or phone

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 Dialysis)
• Rockaway Home Attendant Services, Inc (Rockaway Cdpap Home Care Services)
• Rockaway Home Attendant Services, Inc.
• Rockaway Operations Associates LLC (Far Rockaway Center for Rehabilitation and Nursing)
• 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.