Healthcare Provider Details

I. General information

NPI: 1275681595
Provider Name (Legal Business Name): LOVE WIGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555A N MICHIGAN AVE
KENILWORTH NJ
07033-1076
US

IV. Provider business mailing address

555A N MICHIGAN AVE
KENILWORTH NJ
07033-1076
US

V. Phone/Fax

Practice location:
  • Phone: 800-526-7627
  • Fax: 908-687-9509
Mailing address:
  • Phone: 800-526-7627
  • Fax: 908-687-9509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. ROBERT ANTHONY ANZIVINO
Title or Position: PRESIDENT
Credential:
Phone: 800-526-7627