Provider Demographics
NPI:1003680240
Name:CURALTA MEDICAL LLC
Entity Type:Organization
Organization Name:CURALTA MEDICAL LLC
Other - Org Name:BOLTROPE PODIATRY LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ARIELLE
Authorized Official - Middle Name:ALEXA
Authorized Official - Last Name:DIBATTISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-571-0214
Mailing Address - Street 1:201 STATE RT 17 STE 604
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2574
Mailing Address - Country:US
Mailing Address - Phone:201-571-0214
Mailing Address - Fax:
Practice Address - Street 1:1163 ROUTE 37 W STE B2
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4974
Practice Address - Country:US
Practice Address - Phone:732-349-3039
Practice Address - Fax:732-244-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0899976Medicaid