Organization
BROADWAY COMMUNITY HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK AIME ERVILUS PHD, FNP-C, PMHNP-C (PROVIDER)
(856) 365-1707
Entity
Organization
Contact information
Practice address
442 S BROADWAY, CAMDEN, NJ 08103-1246
(856) 365-1707
(856) 365-1737
Mailing address
442 S BROADWAY, CAMDEN, NJ 08103-1246
(856) 365-1707
(856) 365-1737
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
26NN10322000
NJ
Other
Enumeration date
02/22/2013
Last updated
06/24/2013
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