Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Knickerbocker Dialysis Inc

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1063911659

Knickerbocker Dialysis Inc is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bronx, New York. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
Inc — Incorporated
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) 588-2347
Fax: (718) 293-8906
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1063911659
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Winstel — Chief Accounting Officer · (253) 733-4501
Other names Mount Eden Dialysis
NPI enumeratedFebruary 8, 2018
Last updated in NPPESJanuary 28, 2021
Certification dateJanuary 28, 2021
Mailing address5200 Virginia Way, L&C Dept, Brentwood, TN 37027-7569

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