Organization
SERENITY WIG DESIGN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN LUPO (SOLE PROPRIETOR)
(973) 668-8336
Entity
Organization
Contact information
Practice address
461 US HIGHWAY 46, FAIRFIELD, NJ 07004-1954
(973) 668-8336
Mailing address
65 PITCAIRN DR, ROSELAND, NJ 07068-1019
(973) 668-8336
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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