Organization
PROACTIVE FOOT AND ANKLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY GEWIRTZ (MANAGING PARTNER)
(201) 391-1113
Entity
Organization
Contact information
Practice address
64 FAIRVIEW AVE, WESTWOOD, NJ 07675-2241
(201) 664-0225
Mailing address
74 PASCACK RD STE 6, PARK RIDGE, NJ 07656-1942
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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