Broadway Family Practice, Pc

LBN: Broadway Family Practice, Pc
Broadway Family Practice, Pc is an health care organization with primary practice located at 22 N Franklin Blvd 2Nd Floor, Pleasantville NJ 08232-2547. The organization recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as the primary health care specialty. Broadway Family Practice, Pc can be contacted via phone (609) 272-0655, or through Regis, Jon M via phone (609) 272-0655.

Contact Information

Primary practice address
22 N Franklin Blvd 2Nd Floor Pleasantville NJ 08232-2547
Phone: (609) 272-0655
Fax: (609) 272-9317
Website:
Map and Directions
Authorized official contact:
Name: Regis, Jon M Doctor of Medicine (MD)
Phone: (609) 272-0655

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X New Jersey

Profile Details

NPI number 1255775821
LBN Legal business name Broadway Family Practice, Pc
DBA Doing business as
Authorized official Regis, Jon M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 25th, 2013
Last updated Apr 25th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255775821 NPPES
New Jersey MEDICAID 0329282

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