Fablush Medical Wig

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

FABLUSH MEDICAL WIG

Practice address

720 Livingston St
Elizabeth, NJ 07201-2817

Phone

(862) 201-5411

NPI assigned

Apr 22, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aminat Adams, RN

Title

Ceo

Phone

(862) 244-8947

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1194570218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 LIVINGSTON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012817",
            "telephone_number": "862-201-5411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 LIVINGSTON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012817",
            "telephone_number": "862-201-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FABLUSH MEDICAL WIG",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "AMINAT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "862-244-8947",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.