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Imperial Shoe Store Co Inc
Prosthetic/Orthotic Supplier in Jersey City, New Jersey
NPI 1619193976

Imperial Shoe Store Co Inc is a Prosthetic/Orthotic Supplier based in Jersey City, NJ. Imperial Shoe Store Co Inc practices in Jersey City, NJ. The NPI Number for Imperial Shoe Store Co Inc is 1619193976 and holds a License No. (New Jersey).

The current practice location address for Imperial Shoe Store Co Inc is 516 West Side Ave, Jersey City, NJ and can be reached out via phone at 201-333-0419 and via fax at 201-333-8087.

Location: 516 West Side Ave, Jersey City, NJ, 07304-1516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1619193976
Provider Name
Imperial Shoe Store Co Inc
Credential
Provider Entity Type
Organization
Address
516 West Side Ave, Jersey City, NJ, 07304-1516
Phone Number
201-333-0419
Fax Number
201-333-8087
Provider Enumeration Date
04/17/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5517702 05 NJ
institution
Provider Business Practice Location Address Details
Address
516 West Side Ave
City
Jersey City
State
New Jersey
Zip
07304-1516
Phone Number
201-333-0419
Fax Number
201-333-8087
person
Provider Business Mailing Address Details
Address
516 West Side Ave
City
Jersey City
State
New Jersey
Zip
07304-1516
Phone Number
201-333-0419
Fax Number
201-333-8087
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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