Provider Demographics
NPI:1083285605
Name:SIMPLY TIMELESS BEAUTY LLC
Entity Type:Organization
Organization Name:SIMPLY TIMELESS BEAUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NGOCTU
Authorized Official - Middle Name:THI
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-330-4799
Mailing Address - Street 1:657 E BAY AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3363
Mailing Address - Country:US
Mailing Address - Phone:732-330-4799
Mailing Address - Fax:
Practice Address - Street 1:657 E BAY AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3363
Practice Address - Country:US
Practice Address - Phone:732-330-4799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Single Specialty