# BROAD STREET WELLNESS CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235371576
- **Authorized official:** MARINA BELOZERSKY CPA (OFFICE MANAGER)
- **Authorized official phone:** (973) 614-9500

## Contact information

- **Practice address:** 642 BROAD ST, 2ND FL; STE 9, CLIFTON, NJ 07013-1615
- **Practice address phone:** (973) 614-9500
- **Mailing address:** PO BOX 476, ROSELAND, NJ 07068-0476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NJ | Yes |

## Other

- **Enumeration date:** 04/01/2009
- **Last updated:** 06/17/2009