Provider Demographics
NPI:1568042273
Name:BISYATA DISHMAYA MANAGEMENT SERVICES INC.
Entity Type:Organization
Organization Name:BISYATA DISHMAYA MANAGEMENT SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:TEITELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PEDORTHIST
Authorized Official - Phone:718-782-0600
Mailing Address - Street 1:928 46TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2331
Mailing Address - Country:US
Mailing Address - Phone:718-782-0600
Mailing Address - Fax:718-782-0611
Practice Address - Street 1:41 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3054
Practice Address - Country:US
Practice Address - Phone:718-782-0600
Practice Address - Fax:718-782-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment