Provider Demographics
NPI:1508616301
Name:THE BEAUTY SOURCE INC.
Entity Type:Organization
Organization Name:THE BEAUTY SOURCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZOOHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHRIQI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-209-5155
Mailing Address - Street 1:16602 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1253
Mailing Address - Country:US
Mailing Address - Phone:929-390-2862
Mailing Address - Fax:718-223-5701
Practice Address - Street 1:16602 76TH AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1253
Practice Address - Country:US
Practice Address - Phone:929-390-2862
Practice Address - Fax:718-223-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty