Provider Demographics
NPI:1578908174
Name:WOOD, PAULA ANNE (HAIR DRESSER/COSMETI)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANNE
Last Name:WOOD
Suffix:
Gender:F
Credentials:HAIR DRESSER/COSMETI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BOSTON POST RD
Mailing Address - Street 2:12
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3567
Mailing Address - Country:US
Mailing Address - Phone:203-799-8510
Mailing Address - Fax:203-799-8510
Practice Address - Street 1:501 BOSTON POST RD
Practice Address - Street 2:12
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3567
Practice Address - Country:US
Practice Address - Phone:203-799-8510
Practice Address - Fax:203-799-8510
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038613332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies