| New Broadway Medical Pllc | |
|
501 South Broadway Hicksville NY 11801 | |
| (917) 903-3885 | |
| Not Available |
| Full Name | New Broadway Medical Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 501 South Broadway, Hicksville, New York |
| Authorized Official Name and Position | Himanshu Pandya (PRESIDENT) |
| Authorized Official Contact | 9179033885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Broadway Medical Pllc 427 Links Dr Roslyn NY 11576 Ph: (917) 903-3885 | New Broadway Medical Pllc 501 South Broadway Hicksville NY 11801 Ph: (917) 903-3885 |
| NPI Number | 1689346116 |
|---|---|
| Provider Enumeration Date | 10/03/2021 |
| Last Update Date | 10/03/2021 |
| Medicare PECOS PAC ID | 8820487754 |
|---|---|
| Medicare Enrollment ID | O20211116001080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689346116 | NPI | - | NPPES |
| 02637938 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Himanshu Pandya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003896929 PECOS PAC ID: 3870558182 Enrollment ID: I20041129000664 |
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