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Laspina Renewed Image Salon
Prosthetic/Orthotic Supplier in Mahopac, New York
NPI 1104105055

Laspina Renewed Image Salon is a Prosthetic/Orthotic Supplier based in Mahopac, NY. Laspina Renewed Image Salon practices in Mahopac, NY. The NPI Number for Laspina Renewed Image Salon is 1104105055 and holds a License No. 21SU0072981 (New York).

The current practice location address for Laspina Renewed Image Salon is 947 S Lake Blvd, Mahopac, NY and can be reached out via phone at 845-628-3439 and via fax at 845-628-4838.

Location: 947 S Lake Blvd, Mahopac, NY, 10541-3254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104105055
Provider Name
Laspina Renewed Image Salon
Credential
Provider Entity Type
Organization
Address
947 S Lake Blvd, Mahopac, NY, 10541-3254
Phone Number
845-628-3439
Fax Number
845-628-4838
Provider Enumeration Date
08/10/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
21SU0072981 01 NY OPERARATING AN APPEARANCE ENHANCEMENT BUSINESS LICENSE
institution
Provider Business Practice Location Address Details
Address
947 S Lake Blvd
City
Mahopac
State
New York
Zip
10541-3254
Phone Number
845-628-3439
Fax Number
845-628-4838
person
Provider Business Mailing Address Details
Address
947 S Lake Blvd
City
Mahopac
State
New York
Zip
10541-3254
Phone Number
845-628-3439
Fax Number
845-628-4838
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Customized Equipment
Taxonomy
332BC3200X
License No.
21SU0072981 (New York)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
21SU0072981 (New York)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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