Provider Demographics
NPI:1831210186
Name:ADELE AND AGNES INTIMATE APPAREL INC
Entity type:Organization
Organization Name:ADELE AND AGNES INTIMATE APPAREL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-568-4949
Mailing Address - Street 1:56 EAST PALISADE AVENUE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2902
Mailing Address - Country:US
Mailing Address - Phone:201-568-4949
Mailing Address - Fax:201-568-3070
Practice Address - Street 1:56 EAST PALISADE AVENUE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2902
Practice Address - Country:US
Practice Address - Phone:201-568-4949
Practice Address - Fax:201-568-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
0729320001Medicare ID - Type Unspecified