Provider Demographics
NPI:1689914459
Name:KIDNEY CARE AND HYPERTENSION CENTER LLC
Entity Type:Organization
Organization Name:KIDNEY CARE AND HYPERTENSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:XINYE
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-346-4224
Mailing Address - Street 1:150 W END AVE
Mailing Address - Street 2:UL-1 MAIL BOX 13
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-1834
Mailing Address - Country:US
Mailing Address - Phone:646-346-4224
Mailing Address - Fax:
Practice Address - Street 1:150 W END AVE
Practice Address - Street 2:UL-1 MAIL BOX 13
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1834
Practice Address - Country:US
Practice Address - Phone:646-346-4224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-15
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08309600207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty