Irie Salon and Spa

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

IRIE SALON AND SPA

Practice address

895 Palisade Ave
Fort Lee, NJ 07024-4122

Phone

(347) 901-6147

NPI assigned

Jun 10, 2019

Organization subpart

No

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

Authorized official

Name

Miss Sandra Senior, LMT

Title

Lead Therapist, Manager

Phone

(917) 496-4691

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1710546155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244122",
            "telephone_number": "347-901-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244122",
            "telephone_number": "347-901-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIE SALON AND SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "SENIOR",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "LEAD THERAPIST,  MANAGER",
        "authorized_official_telephone_number": "917-496-4691",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY OFFICE OF ATTORNEY GENERAL",
            "identifier": "18KT01097200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.