Provider Demographics
NPI:1871232462
Name:ESDI ENTERPRISE SUPPORT DYNAMICS, INC.
Entity Type:Organization
Organization Name:ESDI ENTERPRISE SUPPORT DYNAMICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICK
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAZAPIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-887-7678
Mailing Address - Street 1:101 WEST END AVENUE
Mailing Address - Street 2:SUITE 5FF
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:646-887-7678
Mailing Address - Fax:
Practice Address - Street 1:101 WEST END AVENUE
Practice Address - Street 2:SUITE 5FF
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:646-887-7678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty