Provider Demographics
NPI:1467159160
Name:LYDER ENTERPRISES INC
Entity Type:Organization
Organization Name:LYDER ENTERPRISES INC
Other - Org Name:NEW HORIZONS HAIR BY BIANCA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED HAIR LOSS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYDER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:917-209-5099
Mailing Address - Street 1:10 E 138TH ST APT 12D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2037
Mailing Address - Country:US
Mailing Address - Phone:917-209-5099
Mailing Address - Fax:
Practice Address - Street 1:124 W 24TH ST STE 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1904
Practice Address - Country:US
Practice Address - Phone:917-209-5099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier