Provider Demographics
NPI:1891437281
Name:MVNY PARTNERS III, LLC
Entity Type:Organization
Organization Name:MVNY PARTNERS III, LLC
Other - Org Name:U.S. RENAL CARE MASONIC CARE COMMUNITY DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:PO BOX 631724
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1724
Mailing Address - Country:US
Mailing Address - Phone:315-624-5640
Mailing Address - Fax:315-624-5735
Practice Address - Street 1:2150 BLEECKER ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1738
Practice Address - Country:US
Practice Address - Phone:315-624-5640
Practice Address - Fax:315-624-5735
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. RENAL CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-07
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment