Provider Demographics
NPI:1801418116
Name:SHOES ON 18 INC
Entity Type:Organization
Organization Name:SHOES ON 18 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEOPOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUSTADT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-633-8800
Mailing Address - Street 1:4520 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1204
Mailing Address - Country:US
Mailing Address - Phone:718-633-8800
Mailing Address - Fax:
Practice Address - Street 1:4520 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1204
Practice Address - Country:US
Practice Address - Phone:718-633-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies