| The Beauty Source Inc. | |
|
16602 76th Ave Fresh Meadows NY 11366-1253 | |
| (929) 390-2862 | |
| (718) 223-5701 |
| Full Name | The Beauty Source Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 16602 76th Ave, Fresh Meadows, New York |
| Authorized Official Name and Position | Zoohra Mashriqi (OWNER) |
| Authorized Official Contact | 9172095155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Beauty Source Inc. 16602 76th Ave Fresh Meadows NY 11366-1253 Ph: (929) 390-2862 | The Beauty Source Inc. 16602 76th Ave Fresh Meadows NY 11366-1253 Ph: (929) 390-2862 |
| NPI Number | 1508616301 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508616301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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