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
215 OLD TAPPAN RD, OLD TAPPAN, NJ 07675-7000
(201) 930-9090
Mailing address
74 PASCACK RD STE 6, PARK RIDGE, NJ 07656-1942
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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