Provider Demographics
NPI:1932299369
Name:DI SALVO SHOE STORE INC
Entity Type:Organization
Organization Name:DI SALVO SHOE STORE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DISALVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-343-4747
Mailing Address - Street 1:6 BATAVIA CITY CENTRE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020
Mailing Address - Country:US
Mailing Address - Phone:585-343-4747
Mailing Address - Fax:585-343-4747
Practice Address - Street 1:6 BATAVIA CITY CENTRE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-343-4747
Practice Address - Fax:585-343-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier