Organization
THE SHOE TRAVELER DIABETIC FOOTWEAR AND MEDICAL SUPPLIES LLC
Active
Organization
THE SHOE TRAVELER DIABETIC FOOTWEAR AND MEDICAL SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA MIGLIACCIO CERTIFIED PEDORTHIST (OWNER/PRESIDENT)
(732) 462-1005
Entity
Organization
Contact information
Practice address
1214 ROUTE 9 S, HOWELL, NJ 07731-3329
(732) 462-1005
(732) 276-2369
Mailing address
647 WINTERBERRY BLVD, JACKSON, NJ 08527-5344
(732) 462-1005
(732) 276-2369
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CERTIFIED PEDORTHIST
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0244414
—
NJ
Enumeration date
12/28/2008
Last updated
09/19/2012
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