Provider Demographics
NPI:1013915222
Name:NEWTOWN DIALYSIS CENTER, INC
Entity Type:Organization
Organization Name:NEWTOWN DIALYSIS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:GANESH
Authorized Official - Last Name:BHAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-366-1111
Mailing Address - Street 1:2314 COLLEGE POINT BLVD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-2526
Mailing Address - Country:US
Mailing Address - Phone:718-728-2222
Mailing Address - Fax:718-932-1236
Practice Address - Street 1:2920 NEWTOWN AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-2129
Practice Address - Country:US
Practice Address - Phone:718-728-2222
Practice Address - Fax:718-932-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003247R261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01773931Medicaid
NY009526OtherEMPIRE BC/BS
NY01773931Medicaid