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

Queens Boulevard Extended Care Facility Dialysis Center LLC

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1619539996

Queens Boulevard Extended Care Facility Dialysis Center LLC is an End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Woodside, New York. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019
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

6111 Queens Blvd
Woodside, NY 11377-4965
Phone: (718) 205-0287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6111 Queens Blvd, Woodside, NY 11377-4965 — (718) 205-0287

Specialties & licences

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

Record details

NPI number1619539996
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Clemenza — Managing Member · (718) 205-0287
Other names Queens Boulevard Extended Care Dialysis Center Llc; Queens Boulevard Extended Care Dialysis Center Llc
NPI enumeratedJuly 8, 2019
Last updated in NPPESDecember 15, 2021
Certification dateDecember 15, 2021
Mailing address6111 Queens Blvd, Woodside, NY 11377-4965

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