Organization Active NPI

Sam Designer Discount Shoes Inc.

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
National Provider Identifier
1154599140
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SAM DESIGNER DISCOUNT SHOES INC.
Practice address
564 E 43Rd St
Brooklyn, NY 11203-5718
Phone
(718) 629-1708
NPI assigned
Feb 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Semyon Balonik
Title
President
Phone
(718) 629-1708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NY Primary

Addresses

Primary practice location

564 E 43Rd St
Brooklyn, NY 11203-5718

Mailing address

564 E 43Rd St
Brooklyn, NY 11203-5718
Phone (718) 629-1708

National Provider Directory

National Provider Directory

Locations

564 E 43rd St
Brooklyn, NY 11203
Phone (718) 629-1708

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154599140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 E 43RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035718",
            "telephone_number": "718-629-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 E 43RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112035718",
            "telephone_number": "718-629-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM DESIGNER DISCOUNT SHOES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BALONIK",
        "authorized_official_first_name": "SEMYON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-629-1708",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.