Healthcare Provider Details

I. General information

NPI: 1669131041
Provider Name (Legal Business Name): CURALTA MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2021
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 FAIRVIEW AVE
WESTWOOD NJ
07675-2241
US

IV. Provider business mailing address

74 PASCACK RD STE 6
PARK RIDGE NJ
07656-1942
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-0225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY GEWIRTZ
Title or Position: MANAGING PARTNER
Credential:
Phone: 201-391-1113