Provider Demographics
NPI:1700847100
Name:BIG GUY FASHIONS CORPORATION
Entity Type:Organization
Organization Name:BIG GUY FASHIONS CORPORATION
Other - Org Name:SYLENE'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-883-8088
Mailing Address - Street 1:2495 US HIGHWAY 1
Mailing Address - Street 2:STE 15
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-4099
Mailing Address - Country:US
Mailing Address - Phone:609-883-8088
Mailing Address - Fax:609-883-7083
Practice Address - Street 1:2495 US HIGHWAY 1
Practice Address - Street 2:STE 15
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-4099
Practice Address - Country:US
Practice Address - Phone:609-883-8088
Practice Address - Fax:609-883-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier