MEDICARE: NEW HARTFORD SHOES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		NY

General Provider Information

NPI Number	:	1538347620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HARTFORD SHOES

Provider Business Mailing Address
First Line	:	4 CAMPION RD
Second Line	:
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-1634
Country	:	US
Telephone Number	:	315-798-9379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 CAMPION RD
Second Line	:
City	:	NEW HARTFORD
State	:	NY
Zip	:	13413-1634
Country	:	US
Telephone Number	:	315-798-9379
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. VIRGINIA B. BULINSKI
Credential	:
Telephone Number	:	315-798-9379

Provider Enumeration Date	:	01/31/2008
Last Update Date	:	08/07/2008

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Directions to “NEW HARTFORD SHOES ” Practice Location

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