| Organization Name: | WIGS PLUS |
| NPI Number: | 1447307343 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NANCY BISSERT (MANAGER) |
| Mailing Address: | 3201 Middle Country Rd Ste 2 Lake Grove |
| State: | NY US |
| Postal Code: | 117552128 |
| Phone Number: | 6317372850 |
| Fax Number: | 6317378765 |
| NPI Enumeration Date: | 01/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |