Provider Demographics
NPI:1740261874
Name:L-M DIALYSIS CORP
Entity type:Organization
Organization Name:L-M DIALYSIS CORP
Other - Org Name:<UNAVAIL>
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 1:187 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2528
Mailing Address - Country:US
Mailing Address - Phone:212-388-0095
Mailing Address - Fax:212-725-3538
Practice Address - Street 1:187 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2528
Practice Address - Country:US
Practice Address - Phone:212-388-0095
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
NY7002145R261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01636819Medicaid
NY005284OtherEMPIRE BLUE CROSS ID #
NY332543Medicare ID - Type UnspecifiedMCARE ID NUMBER