Provider Demographics
NPI:1912882705
Name:EXPRESS WIG BRAIDS INC
Entity type:Organization
Organization Name:EXPRESS WIG BRAIDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLAJUMOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-564-4777
Mailing Address - Street 1:16 HERITAGE DR APT 11
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2034
Mailing Address - Country:US
Mailing Address - Phone:617-564-4777
Mailing Address - Fax:
Practice Address - Street 1:16 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2076
Practice Address - Country:US
Practice Address - Phone:617-564-4777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-09
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier