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General NPI Number Information
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NPI Number | 1740336189
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Entity Type | Organization
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Legal Business Name | FLORAL SHOES
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 188 JERICHO TPKE
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City | FLORAL PARK
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State | NY
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Zip | 11001-2024
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Country | US
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Telephone | 516-354-7402
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Fax |
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Provider Business Mailing Address
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Address Line | 188 JERICHO TPKE
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City | FLORAL PARK
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State | NY
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Zip | 11001-2024
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Country | US
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Telephone | 516-354-7402
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRY MILLER ALTKIN
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Credential | C-PED
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Telephone | 516-354-7402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NY
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