IHS of New York Inc

Primary specialty

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

Legal business name

IHS OF NEW YORK INC

Practice address

7112 Park Ave
Flushing, NY 11365-4105

Phone

(781) 591-4010

Fax

(781) 591-4014

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Kathleen McDonnell

Title

President

Phone

(561) 361-1113

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Queens Dialysis at South Flushing Doing business as

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1891730404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 BROKEN SOUND PKWY",
            "address_2": "SUITE 502",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334872765",
            "telephone_number": "561-443-0743",
            "fax_number": "561-443-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 PARK AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113654105",
            "telephone_number": "781-591-4010",
            "fax_number": "781-591-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHS OF NEW YORK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-361-1113"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01693136",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queens Dialysis at South Flushing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Icilma V Fergus, MD, PLLC
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• Marilou V Ilie, PT
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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Flushing, NY
• Providers in Flushing, 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 Apr 21, 2015; 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.