Beautique Extension

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BEAUTIQUE EXTENSION

Practice address

208 Stafford Ave
Syracuse, NY 13206-3311

Phone

(315) 399-3545

NPI assigned

Jan 26, 2021

Organization subpart

No

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

Authorized official

Name

Ty-Esha Cooper

Title

Owner

Phone

(315) 399-3545

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1396335006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 STAFFORD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063311",
            "telephone_number": "315-399-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 STAFFORD AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063311",
            "telephone_number": "315-399-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIQUE EXTENSION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "TY-ESHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-399-3545"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bearrick, MD
• Kenneth A Beasley, MD
• Faida Beatrice
• Laura Anne Beattie, PNP
• Robert Wayne Beaumont, N.P.
• Xenia G Becher, MSW, LCSW
• Anne Beck, RN
• Emma F Beck, CASAC-T, BSW
• Lauren Beck, M.D.
• Caitlin Becker

• Prosthetic/Orthotic Supplier in Syracuse, NY
• Providers in Syracuse, 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 Jan 26, 2021; 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.