Organization
BROAD STREET WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA BELOZERSKY CPA (OFFICE MANAGER)
(973) 614-9500
Entity
Organization
Contact information
Practice address
642 BROAD ST, 2ND FL; STE 9, CLIFTON, NJ 07013-1615
(973) 614-9500
Mailing address
PO BOX 476, ROSELAND, NJ 07068-0476
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NJ
Other
Enumeration date
04/01/2009
Last updated
06/17/2009
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