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 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Other Service Providers / Specialist is 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
Other Service Providers / Specialist 174400000X
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X

Profile Details

NPI number 1780624031
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 Jun 7th, 2006
Last updated Aug 30th, 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 1780624031 NPPES
New Jersey MEDICAID 5569605

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