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General NPI Number Information
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NPI Number | 1558067405
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Entity Type | Organization
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Legal Business Name | GALI'S COUTURE WIGS CORP.
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 299 EAST SHORE ROAD SUITE 206
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City | GREAT NECK
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State | NY
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Zip | 11023
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Country | US
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Telephone | 516-441-3830
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Fax | 516-441-3844
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Provider Business Mailing Address
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Address Line | 1 BURBURY LANE
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City | GRENT NECK
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State | NY
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Zip | 11023
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Country | US
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Telephone | 516-884-4624
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Fax | 516-441-3844
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Authorized Official
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Title or Position | OWNER
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Name | MR. JONATHAN AMINOFF
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Credential |
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Telephone | 516-884-4624
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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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