Organization
BROADSTREET HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PARVEZ ALAM MD (OWNER)
(201) 332-4600
Entity
Organization
Contact information
Practice address
395 DANFORTH AVE, JERSEY CITY, NJ 07305-1975
(201) 332-4600
(201) 332-4670
Mailing address
395 DANFORTH AVE, JERSEY CITY, NJ 07305-1975
(201) 332-4600
(201) 332-4670
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06755300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7807406
—
NJ
Enumeration date
05/25/2018
Last updated
05/25/2018
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