Metro Shoe Repair

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

METRO SHOE REPAIR

Practice address

116-27 Metropolitan Avenue
Kew Gardens, NY 11415

Phone

(718) 847-1132

NPI assigned

Dec 15, 2008

Organization subpart

No

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

Authorized official

Name

Georgi ItshakNPI 1659518918

Title

Owner

Phone

(718) 847-1132

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Georgi Itshak

  • Durable Medical Equipment & Medical Supplies
  • Kew Gardens, NY
  • NPI 1659518918
  NPD (past) Authorized official

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1265677512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116-27 METROPOLITAN AVENUE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "11415",
            "telephone_number": "718-847-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116-27 METROPOLITAN AVENUE",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "11415",
            "telephone_number": "718-847-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO SHOE REPAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "ITSHAK",
        "authorized_official_first_name": "GEORGI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-847-1132"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Kew Gardens, NY
• Providers in Kew Gardens, NY by specialty
• Customized Equipment (DME) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.