Provider Demographics
NPI:1558067405
Name:GALI'S COUTURE WIGS CORP.
Entity Type:Organization
Organization Name:GALI'S COUTURE WIGS CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-884-4624
Mailing Address - Street 1:1 BURBURY LANE
Mailing Address - Street 2:
Mailing Address - City:GRENT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023
Mailing Address - Country:US
Mailing Address - Phone:516-884-4624
Mailing Address - Fax:516-441-3844
Practice Address - Street 1:299 EAST SHORE ROAD
Practice Address - Street 2:SUITE 206
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023
Practice Address - Country:US
Practice Address - Phone:516-441-3830
Practice Address - Fax:516-441-3844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier