Racebrook Shoes LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

RACEBROOK SHOES LLC

Practice address

554 Boston Post Rd
Suite 341
Orange, CT 06477-3341

Phone

(203) 891-0772

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Frank G Sicsico

Title

President

Phone

(203) 891-0772

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1972698090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 BOSTON POST RD",
            "address_2": "SUITE 341",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773341",
            "telephone_number": "203-891-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 BOSTON POST RD",
            "address_2": "SUITE 341",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773341",
            "telephone_number": "203-891-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACEBROOK SHOES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "SICSICO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-891-0772"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004237154",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zeeshan Pothiawala, PT
• Grace A Potwardowski
• Rebecca Proca
• Joshua Proctor
• Christopher Prokop, LCSW
• Radiancemd
• Christopher Rago, DC
• Sophia Pauline Rakovan, ST
• Natalie Ramadon Unger, PA
• Amy Ramirez, LCSW

• Durable Medical Equipment & Medical Supplies in Orange, CT
• Providers in Orange, CT by specialty
• Durable Medical Equipment & Medical Supplies in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.