Provider Demographics
NPI:1316486483
Name:AAA INSOLES INC
Entity type:Organization
Organization Name:AAA INSOLES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOROL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-816-0728
Mailing Address - Street 1:2805 E 26TH ST
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2747
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2805 E 26TH ST
Practice Address - Street 2:SUITE 3C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2747
Practice Address - Country:US
Practice Address - Phone:917-816-0728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier