Healthcare Provider Details

I. General information

NPI: 1609457670
Provider Name (Legal Business Name): DINI WIGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 THIELLS MOUNT IVY RD
POMONA NY
10970-3020
US

IV. Provider business mailing address

18 THIELLS MOUNT IVY RD
POMONA NY
10970-3020
US

V. Phone/Fax

Practice location:
  • Phone: 845-262-1010
  • Fax: 845-215-0106
Mailing address:
  • Phone: 845-262-1010
  • Fax: 845-215-0106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: YITZHAK WEINBERG
Title or Position: CEO
Credential:
Phone: 347-598-0357