Provider Demographics
NPI:1487637070
Name:KIDNEY CARE ASSOCIATES, PLLC
Entity type:Organization
Organization Name:KIDNEY CARE ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-209-4100
Mailing Address - Street 1:2035 RALPH AVE
Mailing Address - Street 2:SUITE #B5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5300
Mailing Address - Country:US
Mailing Address - Phone:718-209-4100
Mailing Address - Fax:718-209-0715
Practice Address - Street 1:2035 RALPH AVE
Practice Address - Street 2:SUITE #B5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5300
Practice Address - Country:US
Practice Address - Phone:718-209-4100
Practice Address - Fax:718-209-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2348482OtherAETNA US HEALTHCARE-HMO
NY7921147OtherAETNA US HEALTHCARE-PPO
NY2348482OtherAETNA US HEALTHCARE-HMO