Organization
METRO SHOE REPAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGI ITSHAK (OWNER)
(718) 847-1132
Entity
Organization
Contact information
Practice address
116-27 METROPOLITAN AVENUE, KEW GARDENS, NY 11415
(718) 847-1132
Mailing address
116-27 METROPOLITAN AVENUE, KEW GARDENS, NY 11415
(718) 847-1132
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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