Provider Demographics
NPI:1396909784
Name:LASHES BY LIZ DBA WINKS HAIR & LASH STUDIO
Entity type:Organization
Organization Name:LASHES BY LIZ DBA WINKS HAIR & LASH STUDIO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CALANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-774-1215
Mailing Address - Street 1:30 MONMOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-219-9500
Mailing Address - Fax:732-774-1215
Practice Address - Street 1:30 MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701
Practice Address - Country:US
Practice Address - Phone:732-219-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1207110001Medicare NSC
NJ1207110001Medicare UPIN