Provider Demographics
NPI:1215129010
Name:LINGERIE BY SUSAN INC
Entity type:Organization
Organization Name:LINGERIE BY SUSAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMESS COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-549-4343
Mailing Address - Street 1:9 LINCOLN HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-549-4343
Mailing Address - Fax:732-549-4994
Practice Address - Street 1:9 LINCOLN HIGHWAY
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-549-4343
Practice Address - Fax:732-549-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1192100001Medicare NSC