Healthcare Provider Details

I. General information

NPI: 1396909784
Provider Name (Legal Business Name): LASHES BY LIZ DBA WINKS HAIR & LASH STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MONMOUTH ST
RED BANK NJ
07701
US

IV. Provider business mailing address

30 MONMOUTH STREET
RED BANK NJ
07701
US

V. Phone/Fax

Practice location:
  • Phone: 732-219-8600
  • Fax:
Mailing address:
  • Phone: 732-219-9500
  • Fax: 732-774-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH CALANDRA
Title or Position: OWNER
Credential:
Phone: 732-774-1215