OrganizationActive
Beauty Boutique Hair Salon
NPI 1861100638 · Customized Equipment (DME) · Philadelphia, PA
Provider details
- NPI number
- 1861100638
- Entity type
- Organization
- Primary specialty
- Customized Equipment (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Nydisha Boyd, Owner(267) 253-7053
Specialties & taxonomies
Suppliers
- Driver172A00000X
Other Service Providers
- Exclusive Provider Organization302F00000X
Managed Care Organizations
- Preferred Provider Organization305R00000X
Managed Care Organizations
- Point of Service305S00000X
Managed Care Organizations
- Prosthetic/Orthotic Supplier335E00000X
Suppliers
- Private Vehicle347C00000X
Transportation Services
Practice location
29 S 60th St
Philadelphia, PA 19139-3004
Phone: (215) 921-2410
Approximate (ZIP-level) locationGet directions
Mailing address
29 S 60th St
Philadelphia, PA 19139-3004
Registry dates
- Enumerated
- 2022-11-10
- Last updated
- 2023-08-17
- Certified
- 2023-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.