Provider Demographics
NPI:1851782023
Name:WIGS BY BARBARA
Entity Type:Organization
Organization Name:WIGS BY BARBARA
Other - Org Name:PARK RIDGE WIG CENTER, RIVER VALE HOME MEDICAL EQUIPMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PAOLERCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-243-0440
Mailing Address - Street 1:777 MOUNTAIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081
Mailing Address - Country:US
Mailing Address - Phone:973-243-0440
Mailing Address - Fax:
Practice Address - Street 1:777 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081
Practice Address - Country:US
Practice Address - Phone:973-912-0440
Practice Address - Fax:973-467-7843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X, 332B00000X, 332BC3200X, 332BC3200X, 335E00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier