Provider Demographics
NPI:1346129335
Name:SHULY WIGS INC
Entity type:Organization
Organization Name:SHULY WIGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHULAMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:TYBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-851-7778
Mailing Address - Street 1:531 E 9TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5236
Mailing Address - Country:US
Mailing Address - Phone:718-851-7778
Mailing Address - Fax:
Practice Address - Street 1:114 DITMAS AVE STE B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4902
Practice Address - Country:US
Practice Address - Phone:718-851-7778
Practice Address - Fax:718-851-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies