Knickerbocker Dialysis Inc
Knickerbocker Dialysis Inc is a healthcare organization registered as End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Glendale, NY, holding Type 2 (organization) NPI 1043668825 since 2016. The authorized official on file is Samuel Wey, Vp, Licensure & Certification.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1043668825 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Knickerbocker Dialysis Inc |
| Other name | <Unavail> |
| Practice address | 8000 COOPER AVE, Glendale, NY, 11385 |
| Phone | 7183262789 |
| Fax | 7184164269 |
| Enumeration date | 2016-06-02 |
| Last updated in NPPES | 2024-01-29 |
Authorized official
| Name | Samuel Wey |
|---|---|
| Title | Vp, Licensure & Certification |
| Phone | 6153416641 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QE0700X | End-Stage Renal Disease (ESRD) Treatment Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05397388 | Medicaid | NY | — |
Copy-ready billing details
Provider: Knickerbocker Dialysis Inc NPI: 1043668825 Taxonomy: 261QE0700X (End-Stage Renal Disease (ESRD) Treatment Clinic/Center) Address: 8000 COOPER AVE, Glendale, NY, 11385
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1306981485 | Nara Yoon | Individual | Physical Therapist | Glendale, NY |
| 1992944672 | Judith Mangusan | Individual | Physical Therapist | Glendale, NY |
Verify this record
Cross-check NPI 1043668825 against the authoritative CMS record: view Knickerbocker Dialysis Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Knickerbocker Dialysis Inc?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2024-01-29.