Provider Demographics
NPI:1639211543
Name:SOLEMATES
Entity Type:Organization
Organization Name:SOLEMATES
Other - Org Name:CRISANTI SHOES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:C PED
Authorized Official - Phone:908-276-1462
Mailing Address - Street 1:304 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3139
Mailing Address - Country:US
Mailing Address - Phone:908-276-1462
Mailing Address - Fax:908-276-3097
Practice Address - Street 1:304 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3139
Practice Address - Country:US
Practice Address - Phone:908-276-1462
Practice Address - Fax:908-276-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0176970001Medicare ID - Type Unspecified