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General NPI Number Information
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NPI Number | 1437764800
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Entity Type | Organization
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Legal Business Name | SAFARI UNISEX SALON INC
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Dates
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Enumeration Date | 09/12/2020
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 1605 BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-1534
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Country | US
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Telephone | 516-569-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-1534
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Country | US
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Telephone | 516-569-5530
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CRANIAL PROSTHETICS
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Name | MRS. ANNETTE MITCHELL
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Credential | COSMETOLOGIST
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Telephone | 516-659-3753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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