Healthcare Provider Details

I. General information

NPI: 1699699942
Provider Name (Legal Business Name): SBA HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 KORY DR
KENDALL PARK NJ
08824-1638
US

IV. Provider business mailing address

2329 STREET RD # 1033
BENSALEM PA
19020-2806
US

V. Phone/Fax

Practice location:
  • Phone: 516-500-0519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DANIYAL QASIM
Title or Position: MEMBER
Credential:
Phone: 516-500-0519