Organization
GIFTED FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL P. VAN NESS (OWNER)
(201) 951-9063
Entity
Organization
Contact information
Practice address
50 SPRING ST, RAMSEY, NJ 07446-1131
(201) 951-9063
Mailing address
72 PROSPECT ST APT A, RAMSEY, NJ 07446-2540
(201) 951-9063
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
03/08/2019
Last updated
03/08/2019
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