Provider Demographics
NPI:1609013499
Name:YEHUDA'S SHOES INC.
Entity Type:Organization
Organization Name:YEHUDA'S SHOES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISKHAKOV
Authorized Official - Suffix:
Authorized Official - Credentials:CFTS
Authorized Official - Phone:646-335-7857
Mailing Address - Street 1:3922 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5804
Mailing Address - Country:US
Mailing Address - Phone:718-438-6954
Mailing Address - Fax:
Practice Address - Street 1:3922 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5804
Practice Address - Country:US
Practice Address - Phone:718-438-6954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment