Organization
SHOP BEAUTY BAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANTELL E JAY (OWNER)
(929) 385-5989
Entity
Organization
Contact information
Practice address
18802A LIBERTY AVE, SAINT ALBANS, NY 11412-1049
(929) 385-5989
(205) 751-9233
Mailing address
21907 143RD RD, LAURELTON, NY 11413-3114
(929) 385-5989
(205) 751-9233
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
01/01/2026
Last updated
01/01/2026
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