Provider Demographics
NPI:1265798292
Name:RENAL CARE OF ROCKLAND, INC
Entity type:Organization
Organization Name:RENAL CARE OF ROCKLAND, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORIBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-632-5574
Mailing Address - Street 1:131 ROUTE 303
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-5900
Mailing Address - Country:US
Mailing Address - Phone:845-268-2777
Mailing Address - Fax:845-268-7198
Practice Address - Street 1:30 ROUTE 59
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:NY
Practice Address - Zip Code:10901-4811
Practice Address - Country:US
Practice Address - Phone:845-357-0452
Practice Address - Fax:845-357-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment