Provider Demographics
NPI:1154929628
Name:MANJAY LLC
Entity type:Organization
Organization Name:MANJAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOYOSORE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALADE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:617-792-2614
Mailing Address - Street 1:5807 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4115
Mailing Address - Country:US
Mailing Address - Phone:617-792-2614
Mailing Address - Fax:
Practice Address - Street 1:5807 AVENUE M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4115
Practice Address - Country:US
Practice Address - Phone:617-792-2614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)