Organization
SHOE PRO CORP
Active
Other names
Tri State Orthopedic Footwear Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HONG J LEE CERTIFIED PEDORTHIST (PRESIDENT)
(718) 359-3348
Entity
Organization
Contact information
Practice address
14431 41ST AVE, SUITE # L6, FLUSHING, NY 11355-1459
(718) 359-3348
(718) 359-0388
Mailing address
14431 41ST AVE, SUITE # L6, FLUSHING, NY 11355-1459
(718) 359-3348
(718) 359-0388
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
3105
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02620120
—
NY
Enumeration date
07/15/2006
Last updated
05/27/2011
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