Provider Demographics
NPI:1508056672
Name:IF THE SHOE FITS
Entity Type:Organization
Organization Name:IF THE SHOE FITS
Other - Org Name:SILVIO CLEMENTE
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SILVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTE
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:973-586-3771
Mailing Address - Street 1:20 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2704
Mailing Address - Country:US
Mailing Address - Phone:973-586-3771
Mailing Address - Fax:973-586-0419
Practice Address - Street 1:20 BROADWAY
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2704
Practice Address - Country:US
Practice Address - Phone:973-586-3771
Practice Address - Fax:973-586-0419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6708803Medicaid
NJ1009920001Medicare NSC