BROADWAY PHYSICAL THERAPY (NPI# 1649280199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649280199 |
| Entity Type | Organization |
| Organization Name | BROADWAY PHYSICAL THERAPY |
| Practice Address |
289 Broadway Staten Island NY 10310-2004 |
| Practice Telephone | 7184484500 |
| Practice Fax Number | 7184484506 |
| Mailing Telephone | 7184484500 |
| Mailing Fax Number | 7184484506 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOBILE PRUDENCE SIBANDA (OWNER) |
| Authorized Official Telephone | 7184484500 |
| Authorized Official Credential | PHYSICAL THERAPI |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
016088 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02647758 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | BROADWAY PHYSICAL THERAPY AND SPORTS REHABILITATION, LLC | 3016 Ne Broadway, Portland, OR 97232 |
| Indiana Business Entities | BROADWAY PHYSICAL THERAPY INC. | 3512 169th, Hammond, IN 46323-2543 |
| New York State Corporations | BROADWAY PHYSICAL THERAPY, PLLC | 8 Arbor Circle, Edison, Nj 08837 |
| Street Address |
289 BROADWAY |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10310-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710506027 | Sini Bijoy | Student in an Organized Health Care Education/Training Program | 355 Bard Ave Dept of Medicine Villa Bldg 1st Floor, Staten Island, NY 10310 | 2020-04-16 |
| 1497374243 | Isabelle Mulango | Student in an Organized Health Care Education/Training Program | 355 Bard Ave Dep't of Medicine Villa Bldg 1st Floor, Staten Island, NY 10310 | 2020-04-12 |
| 1174152839 | Yvonne Hanna | Student in an Organized Health Care Education/Training Program | 355 Bard Ave Depatment of Medicine, Villa Bldg 1st Floor, Staten Island, NY 10310 | 2020-04-05 |
| 1588293591 | Muhammad Shaheryar Haider | Student in an Organized Health Care Education/Training Program | 355 Bard Ave Dept of Medicine, Villa Bldg 1st Floor, Staten Island, NY 10310 | 2020-04-02 |
| 1427602846 | Mc Queen and Otuyelu Lcsw Wellness | Social Worker | 941 Forest Avenue, Staten Island, NY 10310 | 2019-07-25 |
| 1780240333 | Zeinab Mohammed Kaleemullah | Student in an Organized Health Care Education/Training Program | 355 Bard Avenue Department of Psychiatry, Staten Island, NY 10310 | 2019-05-18 |
| 1164086229 | Francine Fane Foo | Student in an Organized Health Care Education/Training Program | 355 Bard Ave., Depart of Medicine Villa Bldg 1st Floor, Staten Island, NY 10310 | 2019-04-24 |
| 1528621893 | Francis Njukeng Atemnkeng | Student in an Organized Health Care Education/Training Program | 355 Bard Ave Dept of Medicine Villa Bldg, 1st Floor, Staten Island, NY 10310 | 2019-04-22 |
| 1467015966 | Anum Humayun | Student in an Organized Health Care Education/Training Program | 355 Bard Ave. Dept of Medicine Villa Bldg 1st Floor, Staten Island, NY 10310 | 2019-04-19 |
| 1760951842 | Syed M Faizaan Zabiullah | Student in an Organized Health Care Education/Training Program | 355 Bard Avenue, Department of Medicine, Villa Building, 1st Floor,staten Island, New York, NY 10310 | 2018-11-18 |
| Find all providers in zip 10310 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740892421 | Total Cure Pt PC | Clinic/Center | 620 Bloomingdale Rd, Staten Island, NY 10309-2028 | 2020-08-23 |
| 1215550363 | Target Physical Therapy PC | Clinic/Center | 483 Ingram Ave, Staten Island, NY 10314-4414 | 2020-05-24 |
| 1205337300 | Ryan Dinneny | Clinic/Center | 19 Emmet Ave, Staten Island, NY 10306-2719 | 2018-02-23 |
| 1730699448 | Therapy Masters, LLC | Clinic/Center | 1434 Forest Hill Rd, Staten Island, NY 10314-6318 | 2017-10-08 |
| 1205358025 | Big City Physical Therapy, Pllc | Clinic/Center | 3202 Morley Ave, Staten Island, NY 10306-1906 | 2017-07-13 |
| 1821474263 | M.e.p.t. Physical Therapy, P.C. | Clinic/Center | 322 Lathrop Ave, Staten Island, NY 10302-2532 | 2015-08-07 |
| 1689051260 | Precious Movements Physical Therapy, P.C. | Clinic/Center | 1592 Richmond Ave, Staten Island, NY 10314-1529 | 2015-05-02 |
| 1710011465 | Lugo Comprehensive Pt Services | Clinic/Center | 515 Neckar Ave, Staten Island, NY 10304-4511 | 2007-03-15 |
| 1528179306 | Richard P Orsini | Clinic/Center | 104 Amaron Ln, Staten Island, NY 10307-1963 | 2006-08-31 |
| 1255442034 | Larry Codner | Clinic/Center | 116 Hampton Grn, Staten Island, NY 10312-1739 | 2006-08-31 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10310 |
Please comment or provide details below to improve the information on BROADWAY PHYSICAL THERAPY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.