Provider Demographics
NPI:1619191343
Name:CHINATOWN KIDNEY CARE, PLLC.
Entity Type:Organization
Organization Name:CHINATOWN KIDNEY CARE, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:WEI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-966-0808
Mailing Address - Street 1:139 CENTRE STREET
Mailing Address - Street 2:SUITE 703
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-966-0808
Mailing Address - Fax:212-966-0880
Practice Address - Street 1:139 CENTRE STREET
Practice Address - Street 2:SUITE 703
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-966-0808
Practice Address - Fax:212-966-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225877174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEW831Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER