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General NPI Number Information
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NPI Number | 1831582196
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Entity Type | Organization
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Legal Business Name | WIGS BY LILLIAN LEE
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 947 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4519
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Country | US
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Telephone | 201-837-6770
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Fax | 201-808-2646
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Provider Business Mailing Address
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Address Line | 947 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4519
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Country | US
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Telephone | 201-837-6770
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Fax | 201-808-2646
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Authorized Official
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Title or Position | OWNER
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Name | LILLIAN LEE
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Credential |
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Telephone | 201-837-6770
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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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