MEDICARE: EUROPEAN CUSTOM HAIR PIECES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1730485079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EUROPEAN CUSTOM HAIR PIECES

Provider Business Mailing Address
First Line	:	1884 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6513
Country	:	US
Telephone Number	:	718-336-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1884 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6513
Country	:	US
Telephone Number	:	718-336-5111
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. ELON EMANUEL
Credential	:
Telephone Number	:	718-336-5111

Provider Enumeration Date	:	02/03/2011
Last Update Date	:	02/03/2011

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Directions to “EUROPEAN CUSTOM HAIR PIECES ” Practice Location

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