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KEW GARDENS DIALYSIS CENTER
NPI 1295931624
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment in Kew Gardens, NY

Active since June 22, 2007
12046 QUEENS BLVD, KEW GARDENS, NY 11415(718) 793-3341(718) 268-1666 Get Directions Write a Review

NPPES record last updated: April 3, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kew Gardens Dialysis Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEW GARDENS DIALYSIS CENTER (NPI 1295931624) is a healthcare organization registered as an end-stage renal disease (esrd) treatment in Kew Gardens, New York and active in the NPI registry since June 2007. The organization lists Dominic Licciardi, Coo, as its authorized official.

NPPES Registry Identity

NPI1295931624
Entity TypeOrganization
Primary Taxonomy261QE0700X
Legal Business NameKEW GARDENS DIALYSIS CENTER
Location Address12046 QUEENS BLVDKew Gardens, NY 11415-1204
Mailing Address97 New Dorp LnStaten Island, NY 10306-2364 · (718) 448-5641 · Fax (718) 876-5969
Phone(718) 793-3341
Fax(718) 268-1666
Organization SubpartNo
Authorized OfficialDominic LicciardiCoo · (718) 987-5942
Enumeration DateJune 22, 2007
Last NPPES UpdateApril 3, 2013
✔ NPI 1295931624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · End-Stage Renal Disease (ESRD) TreatmentAmbulatory Health Care Facilities
Taxonomy Code261QE0700X
12046 QUEENS BLVD, Kew Gardens, NY 11415
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BILLA MIRIAM FISHER RADOS MD
Internal Medicine (Nephrology)
12046 QUEENS BLVD
KEW GARDENS, NY 11415
Queens County (718) 793-3341
FREEDOM CENTER OF KEW GARDENS, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
12046 QUEENS BLVD
KEW GARDENS, NY 11415
Queens County (781) 699-9000
QUEENS REPLACEMENT LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
12046 QUEENS BLVD
KEW GARDENS, NY 11415
Queens County (718) 793-3341
YESENIYA KAMYNINA NP
Nurse Practitioner (Adult Health)
12046 QUEENS BLVD
KEW GARDENS, NY 11415
Queens County (718) 793-3341
DR. MICHAEL M GOLDMAN M.D.
Internal Medicine (Nephrology)
12046 QUEENS BLVD
KEW GARDENS, NY 11415
Queens County (718) 793-3341

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kew Gardens Dialysis Center's NPI number?

The NPI number for Kew Gardens Dialysis Center is 1295931624. It was assigned to this organization in the NPPES registry on June 22, 2007.

Where is Kew Gardens Dialysis Center located?

Kew Gardens Dialysis Center is located at 12046 Queens Blvd, Kew Gardens, NY 11415. The listed phone number is (718) 793-3341.

What is Kew Gardens Dialysis Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment, with taxonomy code 261QE0700X.

When was this NPI record last updated?

The NPPES record for Kew Gardens Dialysis Center was last updated on April 3, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.