Provider Demographics
NPI:1760796312
Name:PRESAIAH HOLDING INC
Entity Type:Organization
Organization Name:PRESAIAH HOLDING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:OLANIYI
Authorized Official - Last Name:FALAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-789-7373
Mailing Address - Street 1:221 BROADWAY STE 206
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2700
Mailing Address - Country:US
Mailing Address - Phone:631-789-7373
Mailing Address - Fax:631-789-7383
Practice Address - Street 1:221 BROADWAY STE 206
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2700
Practice Address - Country:US
Practice Address - Phone:631-789-7373
Practice Address - Fax:631-789-7383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies