Organization
SHOP BEAUTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTELL E JAY (OWNER)
(929) 385-5989
Entity
Organization
Contact information
Practice address
18802 LIBERTY AVE, SAINT ALBANS, NY 11412-1049
(929) 385-5989
(205) 751-9233
Mailing address
18802 LIBERTY AVE, SAINT ALBANS, NY 11412-1049
(929) 385-5989
(205) 751-9233
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
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