Provider Demographics
NPI:1215378161
Name:NEW YORK DIALYSIS SERVICES, INC.
Entity Type:Organization
Organization Name:NEW YORK DIALYSIS SERVICES, INC.
Other - Org Name:FMS - SOUTHERN MANHATTAN DIALYSIS CENTER (MONROE COUNTY)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:1150 CROSSPOINTE LN STE 4
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2995
Mailing Address - Country:US
Mailing Address - Phone:585-872-7395
Mailing Address - Fax:585-872-5779
Practice Address - Street 1:1150 CROSSPOINTE LN STE 4
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2995
Practice Address - Country:US
Practice Address - Phone:585-872-7395
Practice Address - Fax:585-872-5779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-08
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY039686696Medicaid
NY039686696Medicaid