Provider Demographics
NPI:1689266306
Name:JACK GOLD SURGICAL APPLIANCES, INC.
Entity Type:Organization
Organization Name:JACK GOLD SURGICAL APPLIANCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-328-3340
Mailing Address - Street 1:1900 S BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-2304
Mailing Address - Country:US
Mailing Address - Phone:267-443-1066
Mailing Address - Fax:267-892-3734
Practice Address - Street 1:1900 S BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-2304
Practice Address - Country:US
Practice Address - Phone:267-443-1066
Practice Address - Fax:267-892-3734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier