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General NPI Number Information
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NPI Number | 1497797898
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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 | 06/11/2006
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 300 EAST BROWN STREET SUITE B
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3007
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Country | US
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Telephone | 570-420-9900
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Fax | 570-420-4529
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Provider Business Mailing Address
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Address Line | 300 EAST BROWN STREET SUITE B
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301-3007
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Country | US
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Telephone | 570-420-9900
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Fax | 570-420-4529
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN P 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 | 6000005108
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License Number State | PA
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