Pristine Wigs

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PRISTINE WIGS

Practice address

15306 78TH Ave
Flushing, NY 11367-3439

Phone

(347) 281-0496

NPI assigned

Jun 22, 2022

Organization subpart

No

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

Authorized official

Name

Diana Yakubova

Title

Medical Wig Specialist

Phone

(347) 281-0496

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1275264020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15306 78TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673439",
            "telephone_number": "347-281-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15306 78TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673439",
            "telephone_number": "347-281-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE WIGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "YAKUBOVA",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "MEDICAL WIG SPECIALIST",
        "authorized_official_telephone_number": "347-281-0496"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Pristinewigs@gmail.com",
            "affiliation": "N",
            "address_1": "15306 78th Ave",
            "city": "Flushing",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113673439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Flushing, NY
• Providers in Flushing, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; 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.