| Organization Name: | SOUTH SHORE DIALYSIS INC. - BELLMORE |
| NPI Number: | 1083657464 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CORENE KORBA (BILLING MANAGER) |
| Mailing Address: | 250 Pettit Ave Bellmore |
| State: | NY US |
| Postal Code: | 117103657 |
| Phone Number: | 5166793090 |
| Fax Number: | |
| NPI Enumeration Date: | 06/14/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 2906202R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |