Provider Demographics
NPI:1942326806
Name:REBECCA A FILKOFF
Entity Type:Organization
Organization Name:REBECCA A FILKOFF
Other - Org Name:NATIONWIDE WIG IMPORTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FILKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-231-0020
Mailing Address - Street 1:9 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-2128
Mailing Address - Country:US
Mailing Address - Phone:860-231-0020
Mailing Address - Fax:860-231-0021
Practice Address - Street 1:9 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2128
Practice Address - Country:US
Practice Address - Phone:860-231-0020
Practice Address - Fax:860-231-0021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004095619Medicaid
CT5602092OtherDME -- WIGS