Healthcare Provider Details

I. General information

NPI: 1346168457
Provider Name (Legal Business Name): NYOH HAIR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 CENTRAL AVE APT 1H
LAWRENCE NY
11559-1565
US

IV. Provider business mailing address

230 CENTRAL AVE APT 1H
LAWRENCE NY
11559-1565
US

V. Phone/Fax

Practice location:
  • Phone: 212-751-4247
  • Fax: 212-751-4247
Mailing address:
  • Phone: 212-751-4247
  • Fax: 212-751-4247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JANET PRUSA
Title or Position: CLINICAL MANAGER
Credential:
Phone: 212-751-4247