Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Concourse Replacement LLC

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1740400431

Concourse Replacement LLC is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bronx, New York. Works from 2 locations. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1490 Macombs Rd
Bronx, NY 10452-2101
Phone: (718) 583-1800
Fax: (718) 583-4160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1780 Grand Concourse, Bronx, NY 10457-5500 — (718) 583-1800

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary) Taxonomy 261QE0700X

Record details

NPI number1740400431
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dominic Licciardi — Administrator · (718) 987-5942
Other names Grand Concourse Dialysis Facility; Grand Concourse Dialysis Facility
NPI enumeratedApril 26, 2007
Last updated in NPPESMarch 1, 2026
Certification dateMarch 1, 2026
Mailing address97 New Dorp Ln, Staten Island, NY 10306-1796

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