Provider Demographics
NPI:1134665805
Name:ALARIS HEALTH DIALYSIS AT ESSEX LLC
Entity Type:Organization
Organization Name:ALARIS HEALTH DIALYSIS AT ESSEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENREICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-216-9500
Mailing Address - Street 1:35 JOURNAL SQ
Mailing Address - Street 2:1103
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4007
Mailing Address - Country:US
Mailing Address - Phone:201-216-9500
Mailing Address - Fax:201-216-9656
Practice Address - Street 1:155 40TH ST
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111-1184
Practice Address - Country:US
Practice Address - Phone:201-216-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment