Shoe Pro Corp

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

3105 Issued in NY

Legal business name

SHOE PRO CORP

Practice address

14431 41St Ave
Suite # L6
Flushing, NY 11355-1459

Phone

(718) 359-3348

Fax

(718) 359-0388

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Hong J Lee, CERTIFIED PEDORTHIST

Title

President

Phone

(718) 359-3348

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tri State Orthopedic Footwear Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Young Song, CPED

  • Pedorthist
  • Flushing, NY
  • NPI 1043751514
  NPD
• Ying Chen, CPED

  • Pedorthist
  • Flushing, NY
  • NPI 1174329171
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1386660751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14431 41ST AVE",
            "address_2": "SUITE # L6",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551459",
            "telephone_number": "718-359-3348",
            "fax_number": "718-359-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 41ST AVE",
            "address_2": "SUITE # L6",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113551459",
            "telephone_number": "718-359-3348",
            "fax_number": "718-359-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOE PRO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "HONG J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-359-3348",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CERTIFIED PEDORTHIST"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NY",
            "license": "3105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02620120",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri State Orthopedic Footwear Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eliana Shkedy, RD
• Natalie Shlomo, LMSW
• Amy Shluker
• Ilene Shmuel
• Nakao James Shoda, DDS
• Yael Tzipora Sholomov
• Dong-Hong Shong, M.D.
• Shop -N- Save Pharmacy Inc
• Jialu Shou, RD
• Martine Showers, CRNA

• Prosthetic/Orthotic Supplier in Flushing, NY
• Providers in Flushing, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.