Estetica de Ella Salon (Cranial Prosthesis)

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

FA0026088 Issued in NM

Legal business name

ESTETICA DE ELLA SALON (CRANIAL PROSTHESIS)

Practice address

2510 San Mateo PL NE
Albuquerque, NM 87110-4064

Phone

(505) 830-3333

Fax

(505) 881-2857

NPI assigned

Sep 27, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Javier Torres

Title

President/Owner

Phone

(505) 830-3333

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1639488588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 SAN MATEO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104064",
            "telephone_number": "505-830-3333",
            "fax_number": "505-881-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 SAN MATEO PL NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104064",
            "telephone_number": "505-830-3333",
            "fax_number": "505-881-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTETICA DE ELLA SALON (CRANIAL PROSTHESIS)",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "505-830-3333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NM",
            "license": "FA0026088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Prosthetic/Orthotic Supplier in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.