1730663493 NPI number — PRIVATE QUARTERS HAIR SALON LLC

Table of content: MICHAEL C BOWER MD (NPI 1700814936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730663493 NPI number — PRIVATE QUARTERS HAIR SALON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRIVATE QUARTERS HAIR SALON LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730663493
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
73 WHIPPANY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-313-0001
Provider Business Mailing Address Fax Number:
862-766-6664

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 ACADEMY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-313-0001
Provider Business Practice Location Address Fax Number:
862-766-6664
Provider Enumeration Date:
09/19/2018

Additional Information

Authorized Official

Authorized Official Last Name:
FRANKLIN
Authorized Official First Name:
RACHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
973-220-5096

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com