Organization
LONG ISLAND COMFORT SHOES AND PEDORTHIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP JOSEPH CELESTINO C. PED. (CERTIFIED PEDORTHIST)
(631) 476-9717
Entity
Organization
Contact information
Practice address
403 E MAIN ST, PORT JEFFERSON, NY 11777-1843
(631) 476-9717
(631) 476-9718
Mailing address
403 E MAIN ST, PORT JEFFERSON, NY 11777-1843
(631) 476-9717
(631) 476-9718
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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