Provider Demographics
NPI:1437273505
Name:TURNPIKE ORTHOPEDIC SHOES INC.
Entity Type:Organization
Organization Name:TURNPIKE ORTHOPEDIC SHOES INC.
Other - Org Name:TURNPIKE COMFORT FOOTWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:RUEDA
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPED
Authorized Official - Phone:718-454-5870
Mailing Address - Street 1:18606 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1734
Mailing Address - Country:US
Mailing Address - Phone:718-454-5870
Mailing Address - Fax:718-264-2104
Practice Address - Street 1:18606 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11366-1734
Practice Address - Country:US
Practice Address - Phone:718-454-5870
Practice Address - Fax:718-264-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0552150001Medicare ID - Type Unspecified