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Northeast Philadelphia Dialysis Center LLC

Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Philadelphia, PA. Organization (NPI-2).

NPI number1093229809
StatusActive
Last updated in NPPESJul 8, 2026

Details

NPI
1093229809
Entity type
Organization (NPI-2)
Legal business name
Northeast Philadelphia Dialysis Center LLC
Organization subpart
No
Enumeration date
Dec 1, 2017
Certification date
Jul 8, 2026
Last updated
Jul 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment––Yes

Practice location

9815 Roosevelt Blvd Ste 1-A
Philadelphia, PA 19114-1035

Phone 215-330-0494 · Fax 215-330-0495

Mailing address

9815 Roosevelt Blvd Ste 1-A
Philadelphia, PA 19114-1035

Phone 215-330-0494 · Fax 215-330-0495

Authorized official

Sara Anne Brady
Chief Nursing Officer
2083717878

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