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General NPI Number Information
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NPI Number | 1962084129
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Entity Type | Organization
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Legal Business Name | CP WIGS INC.
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Dates
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Enumeration Date | 04/26/2021
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 1363 57TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4637
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Country | US
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Telephone | 718-686-6555
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Fax |
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Provider Business Mailing Address
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Address Line | 1363 57TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-4637
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Country | US
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Telephone | 646-276-8080
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHAIM PESACH
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Credential |
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Telephone | 374-263-4563
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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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