Provider Demographics
NPI:1396320032
Name:MOTOLA MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:MOTOLA MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-613-9095
Mailing Address - Street 1:772B SUTTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-4321
Mailing Address - Country:US
Mailing Address - Phone:347-789-1398
Mailing Address - Fax:718-228-6861
Practice Address - Street 1:772B SUTTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-4321
Practice Address - Country:US
Practice Address - Phone:347-789-1398
Practice Address - Fax:718-228-6861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies