Lower Manhattan Dialysis Center
New Patient Application Form

44 YEAR LEADER IN SAFE DIALYSIS
WE HAVE A PROVEN RECORD OF CLINICAL EXCELLENCE & PATIENT SURVIVAL
HIGH QUALITY INDIVIDUALIZED MEDICAL CARE

323 EAST 34TH ST. 
NEW YORK, NY 10016
Tel:  Please LOGIN
Fax:  Please LOGIN

               If you would like to visit our center, take a tour and speak with our staff
               please fill out the form below & Ms. Mercurius will get back to you ASAP.

Mr./ Ms.:Age :

Address :

City :State : Zip Code :

Telephone # :

E-Mail :

Please enter any questions or comments, 
Ms. Mercurius will reply as soon as possible:


 
 
 

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Lower Manhattan Dialysis Center
323 East 34th St. 
New York, NY 10016
 
                                                        Tel: Please LOGIN
                                                       Fax: Please LOGIN
      E-Mail:  Administrator@LowerManhattanDialysis.com
 
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