Organization Name: | NEWARK RENAL CENTERS, LLC |
NPI Number: | 1366461527 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VICKI L BURRIER (DIRECTOR) |
Mailing Address: | 1529 N Broad St Hillside |
State: | NJ US |
Postal Code: | 072051603 |
Phone Number: | 9734741199 |
Fax Number: | 9734741198 |
NPI Enumeration Date: | 07/19/2006 |
NPI Last Update Date: | 02/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |