# BROADWAY PEDIATRICS M.D.P.C.

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

## Provider details

- **NPI number:** 1891903837
- **Authorized official:** DR. JOSE PEREZ M.D. (PRESIDENT)
- **Authorized official phone:** (212) 740-3900

## Contact information

- **Practice address:** 4250 BROADWAY, SUITE 1C, NEW YORK, NY 10033-3748
- **Practice address phone:** (212) 740-3900
- **Practice address fax:** (212) 740-8232
- **Mailing address:** 4250 BROADWAY, SUITE 1C, NEW YORK, NY 10033-3748
- **Mailing address phone:** (212) 740-3900
- **Mailing address fax:** (212) 740-8232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080H0002X | Pediatric Hospice and Palliative Medicine Physician | — | NY | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 07/07/2011