| Broadway Internal Medicine Pc | |
|
680 Broadway 5th Floor Suite # 502 Paterson NJ 07514-1524 | |
| (973) 278-2877 | |
| Not Available |
| Full Name | Broadway Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 680 Broadway, Paterson, New Jersey |
| Authorized Official Name and Position | Esrel A Avila (MEDICAL DIRECXTOR) |
| Authorized Official Contact | 9732783254 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Internal Medicine Pc 680 Broadway 5th Floor Suite # 502 Paterson NJ 07514-1524 Ph: (973) 278-2877 | Broadway Internal Medicine Pc 680 Broadway 5th Floor Suite # 502 Paterson NJ 07514-1524 Ph: (973) 278-2877 |
| NPI Number | 1992820435 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 04/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992820435 | NPI | - | NPPES |
| 1109502 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA42261 (New Jersey) | Primary |
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