Organization
MODAITALIANASHOESINC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER SALADINO SR. (OWNER)
(718) 946-0833
Entity
Organization
Contact information
Practice address
112AVENUE.U, BROOKLYN, NY 11223
(718) 946-0833
Mailing address
112 AVENUE U, BROOKLYN, NY 11223-3603
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/28/2011
Last updated
04/28/2011
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