Comfort Your Sole, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

C.PED0428 Issued in NY

Legal business name

COMFORT YOUR SOLE, INC

Practice address

546 Commack Rd
Deer Park, NY 11729-3804

Phone

(631) 242-4000

Fax

(631) 242-4007

NPI assigned

Jun 27, 2013

Last updated

Jun 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mi K Kim, C.PED

Title

Owner

Phone

(631) 242-4000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1962842450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 COMMACK RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293804",
            "telephone_number": "631-242-4000",
            "fax_number": "631-242-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 COMMACK RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117293804",
            "telephone_number": "631-242-4000",
            "fax_number": "631-242-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT YOUR SOLE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-27",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-242-4000",
        "authorized_official_credential": "C.PED"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "C.PED0428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.