A Mother's Boutique, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

84060346 Issued in PA

Legal business name

A MOTHER'S BOUTIQUE, LLC

Practice address

145 Lake Dr Ste 102R
Wexford, PA 15090-8473

Phone

(724) 934-8795

Fax

(724) 965-4085

NPI assigned

Feb 22, 2012

Last updated

Feb 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Judy P Masucci, PH.D.

Title

Owner

Phone

(724) 934-8795

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1740553759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LAKE DR STE 102R",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908473",
            "telephone_number": "724-934-8795",
            "fax_number": "724-965-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LAKE DR STE 102R",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908473",
            "telephone_number": "724-934-8795",
            "fax_number": "724-965-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A MOTHER'S BOUTIQUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "MASUCCI",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-934-8795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "84060346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Wexford, PA
• Providers in Wexford, PA by specialty
• Durable Medical Equipment & Medical Supplies in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.