Organization
HAIR ENVY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DORETHA NICOLE BATES (CEO)
(973) 336-0203
Entity
Organization
Contact information
Practice address
423 N 13TH ST APT 4, NEWARK, NJ 07107-1390
(973) 336-0203
Mailing address
P.O. BOX 341, BLOOMFIELD, NJ 07003
(973) 336-0203
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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