Provider Demographics
NPI:1447002274
Name:CURALTA FOOT AND ANKLE PENN PC
Entity type:Organization
Organization Name:CURALTA FOOT AND ANKLE PENN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEWIRTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-391-1113
Mailing Address - Street 1:74 PASCACK RD STE 6
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-1942
Mailing Address - Country:US
Mailing Address - Phone:201-391-1113
Mailing Address - Fax:201-391-1114
Practice Address - Street 1:252 W SWAMP RD STE 202
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2422
Practice Address - Country:US
Practice Address - Phone:215-230-9707
Practice Address - Fax:215-230-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104317515-0001Medicaid