Provider Demographics
NPI:1346221462
Name:LOWER MANHATTAN DIALYSIS CENTER
Entity Type:Organization
Organization Name:LOWER MANHATTAN DIALYSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SINITZKY
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:212-889-0770
Mailing Address - Street 1:323 E 34TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4974
Mailing Address - Country:US
Mailing Address - Phone:212-889-0770
Mailing Address - Fax:212-725-3538
Practice Address - Street 1:323 E 34TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4974
Practice Address - Country:US
Practice Address - Phone:212-889-0770
Practice Address - Fax:212-725-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002124R261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005323OtherEMPIRE BLUE CROSS NUMBER
NY00907873Medicaid
NY005323OtherEMPIRE BLUE CROSS NUMBER