Provider Demographics
NPI:1306884028
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:MANAGER MEMBER CO
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 1:3555 E. TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2017
Mailing Address - Country:US
Mailing Address - Phone:718-828-5300
Mailing Address - Fax:718-828-0026
Practice Address - Street 1:3555 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2017
Practice Address - Country:US
Practice Address - Phone:718-828-5300
Practice Address - Fax:718-828-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5732620001Medicare NSC