Provider Demographics
NPI:1245017177
Name:THE PARRUCCHE GARBIERE WIGS STUDIO, LIMITED LIABILITY CO.
Entity type:Organization
Organization Name:THE PARRUCCHE GARBIERE WIGS STUDIO, LIMITED LIABILITY CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT FOUNDER PRINCIPAL CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PAOLERCIO
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:732-713-9543
Mailing Address - Street 1:21 NORTH ALBANY STREET UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-1164
Mailing Address - Country:US
Mailing Address - Phone:862-271-9417
Mailing Address - Fax:609-328-9447
Practice Address - Street 1:21 NORTH ALBANY AVENUE
Practice Address - Street 2:UNIT 1
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-1164
Practice Address - Country:US
Practice Address - Phone:862-271-9417
Practice Address - Fax:609-328-9447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TPGWS, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-13
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
No224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Multi-Specialty