Provider Demographics
NPI:1588405971
Name:SUPERIOR SKIN CARE AND ELECTROLYSIS
Entity type:Organization
Organization Name:SUPERIOR SKIN CARE AND ELECTROLYSIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ELECTROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHNAYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-913-2373
Mailing Address - Street 1:49 N MAIN ST # A
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3448
Mailing Address - Country:US
Mailing Address - Phone:617-913-2373
Mailing Address - Fax:
Practice Address - Street 1:148 LINDEN ST STE B2
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7915
Practice Address - Country:US
Practice Address - Phone:617-913-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-01
Last Update Date:2024-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization