Healthcare Provider Details
I. General information
NPI: 1689512857
Provider Name (Legal Business Name): SOUKE BEAUTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2094 PLEASANT PKWY
UNION NJ
07083-4348
US
IV. Provider business mailing address
2094 PLEASANT PKWY
UNION NJ
07083-4348
US
V. Phone/Fax
- Phone: 908-494-3965
- Fax: 908-494-3965
- Phone: 908-494-3965
- Fax: 908-494-3965
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
NACIUS
Title or Position: OWNER
Credential:
Phone: 908-494-3965