Studio Pink Hair Lounge Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

STUDIO PINK HAIR LOUNGE INC

Practice address

1375 Jerusalem Ave
Merrick, NY 11566-1342

Phone

(516) 240-0858

NPI assigned

Aug 16, 2024

Organization subpart

No

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

Authorized official

Name

Derrica Keyonna Gomez, CPS

Title

Specialist

Phone

(516) 240-0858

Specialties & licenses 1

Addresses

Other names 1

• Derrica K. Gomez Other name

Locations

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1841022985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 JERUSALEM AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661342",
            "telephone_number": "516-240-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 JERUSALEM AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115661342",
            "telephone_number": "516-240-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUDIO PINK HAIR LOUNGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "DERRICA",
        "authorized_official_middle_name": "KEYONNA",
        "authorized_official_title_or_position": "SPECIALIST",
        "authorized_official_telephone_number": "516-240-0858",
        "authorized_official_credential": "CPS"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Derrica K. Gomez",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Merrick, NY
• Providers in Merrick, 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 Aug 16, 2024; 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.