Provider Demographics
NPI:1154991966
Name:UPTOWN NEW YORK STYLE INC
Entity type:Organization
Organization Name:UPTOWN NEW YORK STYLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LOUTICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIER
Authorized Official - Suffix:
Authorized Official - Credentials:COSMETOLOGIST
Authorized Official - Phone:858-259-6833
Mailing Address - Street 1:2914 LUCIERNAGA ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-5951
Mailing Address - Country:US
Mailing Address - Phone:619-820-0290
Mailing Address - Fax:
Practice Address - Street 1:524 STEVENS AVE STE 9
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2053
Practice Address - Country:US
Practice Address - Phone:858-259-6833
Practice Address - Fax:760-476-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1790193498OtherNPI