Provider Demographics
NPI:1487431375
Name:SATIN HAIR BOUTIQUE, LLC
Entity type:Organization
Organization Name:SATIN HAIR BOUTIQUE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:SATIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-703-8446
Mailing Address - Street 1:54 PARKVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523-3807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 PARKVIEW RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3807
Practice Address - Country:US
Practice Address - Phone:914-703-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier