Broadway Internal Medicine Pc

LBN: Broadway Internal Medicine Pc
Broadway Internal Medicine Pc is an health care organization with primary practice located at 680 Broadway 5Th Floor Suite # 502, Paterson NJ 07514-1524. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Broadway Internal Medicine Pc can be contacted via phone (973) 278-2877, or through Avila, Esrel A via phone (973) 278-3254.

Contact Information

Primary practice address
680 Broadway 5Th Floor Suite # 502 Paterson NJ 07514-1524
Phone: (973) 278-2877
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Avila, Esrel A Doctor of Medicine (MD)
Phone: (973) 278-3254

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 25MA42261 New Jersey

Profile Details

NPI number 1992820435
LBN Legal business name Broadway Internal Medicine Pc
DBA Doing business as
Authorized official Avila, Esrel A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 21st, 2007
Last updated Apr 28th, 2014 - 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 1992820435 NPPES
New Jersey MEDICAID 1109502

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