Provider Demographics
NPI:1700267887
Name:MEDICAL HAIR REPLACEMENT, INC.
Entity Type:Organization
Organization Name:MEDICAL HAIR REPLACEMENT, INC.
Other - Org Name:MHR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:QUARTUCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-438-4839
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-0141
Mailing Address - Country:US
Mailing Address - Phone:914-438-4839
Mailing Address - Fax:
Practice Address - Street 1:9 BLAKE LN
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-6733
Practice Address - Country:US
Practice Address - Phone:914-438-4839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier