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General NPI Number Information
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NPI Number | 1073745535
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Entity Type | Organization
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Legal Business Name | JACK GOLD SURGICAL APPLIANCES, INC.
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 04/04/2021
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Provider Practice Location Address
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Address Line | 25-09 BROADWAY
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City | FAIR LAWN
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State | NJ
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Zip | 07410-3813
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Country | US
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Telephone | 201-444-7750
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Fax | 201-612-1323
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Provider Business Mailing Address
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Address Line | 1 EMERY AVE
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City | RANDOLPH
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State | NJ
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Zip | 07869-1387
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Country | US
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Telephone | 973-328-3340
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Fax | 973-328-3342
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEVEN CUFF
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Credential |
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Telephone | 973-328-3340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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