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General NPI Number Information
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NPI Number | 1235099441
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Entity Type | Organization
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Legal Business Name | EAZYFIT CRANIAL PROSTHETICS LLC
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 4988 WASHINGTON ST
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City | WEST ROXBURY
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State | MA
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Zip | 02132-4747
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Country | US
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Telephone | 857-237-6134
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Fax |
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Provider Business Mailing Address
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Address Line | 51 NORFOLK ST APT C
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City | DORCHESTER CENTER
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State | MA
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Zip | 02124-3576
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Country | US
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Telephone | 857-237-6134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EZRA LIVERPOOL
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Credential |
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Telephone | 857-237-6134
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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 |
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