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General NPI Number Information
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NPI Number | 1710028113
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Entity Type | Organization
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Legal Business Name | BEAUTIFUL LADY INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 155 S LIVINGSTON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3030
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Country | US
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Telephone | 973-994-0291
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Fax |
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Provider Business Mailing Address
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Address Line | 155 S LIVINGSTON AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3030
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Country | US
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Telephone | 973-994-0291
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUZANNE MARY PASSERO
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Credential |
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Telephone | 973-994-0291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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