Provider Demographics
NPI:1689479347
Name:DYNAMIC TECHNOLOGY SUPPLIERS
Entity type:Organization
Organization Name:DYNAMIC TECHNOLOGY SUPPLIERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-554-2248
Mailing Address - Street 1:31 SEATON PL
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31 SEATON PL
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1117
Practice Address - Country:US
Practice Address - Phone:570-554-2248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies