Organization
IMPERIAL SHOE STORE CO INC
Active
Other names
Imperial Shoes
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH PETER MARMORA JR. C PED (VP GEN MANAGER)
(201) 333-0419
Entity
Organization
Contact information
Practice address
516 WEST SIDE AVE, JERSEY CITY, NJ 07304-1516
(201) 333-0419
(201) 333-8087
Mailing address
516 WEST SIDE AVE, JERSEY CITY, NJ 07304-1516
(201) 333-0419
(201) 333-8087
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5517702
—
NJ
Enumeration date
04/17/2007
Last updated
08/22/2020
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