Organization
ORTHO SHOES CORP
Active
Organization
ORTHO SHOES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIYEL ADZHIASHVILI (PRESIDENT)
(917) 304-6657
Entity
Organization
Contact information
Practice address
10032 QUEENS BLVD, FOREST HILLS, NY 11375-2748
(718) 275-0018
Mailing address
10032 QUEENS BLVD, FOREST HILLS, NY 11375-2748
(718) 275-0018
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CPED 3003
DE
Other
Enumeration date
11/05/2009
Last updated
07/08/2020
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