Provider Demographics
NPI:1154935641
Name:HEEL TO TOE FOOT CENTER, LLC,
Entity type:Organization
Organization Name:HEEL TO TOE FOOT CENTER, LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PINCHAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANTAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-828-5300
Mailing Address - Street 1:6407 108TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1603
Mailing Address - Country:US
Mailing Address - Phone:929-810-1001
Mailing Address - Fax:
Practice Address - Street 1:6407 108TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1603
Practice Address - Country:US
Practice Address - Phone:929-810-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies