BROADWAY FAMILY PRACTICE PC (NPI# 1780624031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780624031 |
| Entity Type | Organization |
| Organization Name | BROADWAY FAMILY PRACTICE PC |
| Practice Address |
22 N Franklin Blvd 2nd Floor Pleasantville NJ 08232-2547 |
| Mailing Address |
22 North Franklin Blvd 2nd Floor Pleasantville NJ 08232-2547 |
| Practice Telephone | 6092720655 |
| Practice Fax Number | 6092729317 |
| Mailing Telephone | 6092720655 |
| Mailing Fax Number | 6092729317 |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2013-08-30 |
| Authorized Official Name | DR. JON M. REGIS (PRESIDENT) |
| Authorized Official Telephone | 6092720655 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers | ||
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 5569605 | 05 |
| Street Address |
22 N FRANKLIN BLVD 2ND FLOOR |
| City | PLEASANTVILLE |
| State | NJ |
| Zip Code | 08232-2547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629041850 | Enza P Caputo | Pediatrics | 22 N Franklin Blvd, 1st Floor, Pleasantville, NJ 08232-2547 | 2006-02-08 |
| 1962952572 | Barbara Arnold | Nurse Practitioner | 22 N Franklin Blvd, Pleasantville, NJ 08232-2547 | 2016-10-06 |
| 1255775821 | Broadway Family Practice, PC | Podiatrist | 22 N Franklin Blvd, 2nd Floor, Pleasantville, NJ 08232-2547 | 2013-04-25 |
| 1801110499 | Egidio Migioia | Nurse Practitioner | 22 N Franklin Blvd, Pleasantville, NJ 08232-2547 | 2010-03-25 |
| 1295994853 | Jacob Franklin Cogen | Family Medicine | 22 N Franklin Blvd, 2nd Floor, Pleasantville, NJ 08232-2547 | 2008-06-08 |
| 1629124136 | Els Sincebaugh | Physician Assistant | 22 N Franklin Blvd, 2nd Floor, Pleasantville, NJ 08232-2547 | 2007-01-26 |
| 1861555294 | Reliance Medical Group LLC | Specialist | 22 N Franklin Blvd, 2nd Floor, Pleasantville, NJ 08232-2547 | 2006-12-18 |
| 1528078797 | Laura J Bonaker | Pediatrics | 22 N Franklin Blvd, 1st Floor, Pleasantville, NJ 08232-2547 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538533088 | Caringhouse Projects, Inc | Respite Care | 411b West Delilah Road, Pleasantville, NJ 08232 | 2015-11-20 |
| 1295108249 | Caringhouse Projects, Inc | Respite Care | 700 Franklin Blvd, Apt 601, Pleasantville, NJ 08232 | 2015-11-12 |
| 1205209251 | Caringhouse Projects, Inc | Respite Care | 411a West Delilah Road, Pleasantville, NJ 08232 | 2015-11-12 |
| 1215368568 | Priority Care Transport LLC | Non-emergency Medical Transport (VAN) | 590 W. Delilah Rd, Pleasantville, NJ 08232 | 2013-12-11 |
| 1053601773 | Bhavesh C Bhatt | Pharmacist | 855 North Main Street, Rite Aid Pharmacy, Pleasantville, NJ 08232 | 2011-04-14 |
| 1407158694 | Tricare Medical Transportation, LLC | Ambulance | 825 Noahs Road, Pleasantville, NJ 08232 | 2010-11-22 |
| 1174833495 | Laverne Graves-washington | Registered Nurse | 268 North New Rd., Pleasantville, NJ 08232 | 2010-10-20 |
| 1619284429 | Bhakti Chaudhari | Pharmacist | 855-857 North Main Street, Rite Aid Pharmacy, Pleasantville, NJ 08232 | 2010-09-01 |
| 1013222546 | Pradip N Agrawal | Pharmacist | 505 Black Horse Pike, Pleasantville, NJ 08232 | 2010-08-09 |
| 1144533845 | Arnold Snyder | Pharmacist | 505 Blackhorse Pk, Pleasantville, NJ 08232 | 2010-07-22 |
| Find all providers in zip 08232 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942780200 | Jaya Crawford | Specialist | 158 Pleasantville Rd, Pleasantville, NY 10570-2719 | 2018-08-16 |
| 1013410828 | Colleen Brennan | Specialist | 261 Washington Ave, Pleasantville, NY 10570-2038 | 2018-03-18 |
| 1114449691 | Ahimsa Maria Luciano | Specialist | 196 Washington Ave, Pleasantville, NY 10570-2018 | 2017-07-17 |
| 1487009890 | Danielle Meyer | Specialist | 527 Bear Ridge Rd, Pleasantville, NY 10570-2504 | 2016-05-04 |
| 1700280880 | Laronne Quarles | Specialist | 120 W Edgewater Ave, Pleasantville, NJ 08232-3412 | 2014-10-17 |
| 1982013637 | Luisa Oakley | Specialist | 76 Brook Mnr, Pleasantville, NY 10570-2416 | 2014-08-07 |
| 1578809331 | Tahirah Campbell | Specialist | 34 Lenox Ave, Pleasantville, NY 10570-3214 | 2012-12-26 |
| 1982971230 | Denise T. Corriveau | Specialist | 82 Birch Dr, Pleasantville, NY 10570-3302 | 2011-11-30 |
| 1902809742 | Abdul Qadir | Specialist | 1004 S New Rd, Pleasantville, NJ 08232-3730 | 2005-05-24 |
| 1952525164 | Diane Demaio-feldman | Specialist | 700 N Main St, Pleasantville, NJ 08232-1515 | 2007-04-12 |
| Find all providers in PLEASANTVILLE | ||||
| City | PLEASANTVILLE |
| Zip Code | 08232 |
Please comment or provide details below to improve the information on BROADWAY FAMILY PRACTICE PC.
| 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.