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General NPI Number Information
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NPI Number | 1053606392
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Entity Type | Organization
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Legal Business Name | LUCINDAS HAIR
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 650 HIGHLAND AVE
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City | CHESHIRE
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State | CT
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Zip | 06410-2207
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Country | US
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Telephone | 203-272-1585
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Fax | 203-272-2602
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Provider Business Mailing Address
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Address Line | 650 HIGHLAND AVE
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City | CHESHIRE
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State | CT
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Zip | 06410-2207
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Country | US
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Telephone | 203-272-1585
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Fax | 203-272-2602
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Authorized Official
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Title or Position | OWNER
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Name | MS. LUCINDA DOROTHY BEATY
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Credential | HAIRSTYLIST
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Telephone | 203-272-1585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | CT
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