Organization
BROADWAY MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAURICIO VELASCO MD (OWNER)
(201) 864-3456
Entity
Organization
Contact information
Practice address
6500 BROADWAY, WEST NEW YORK, NJ 07093-3112
(201) 864-3456
(201) 869-7224
Mailing address
6500 BROADWAY, WEST NEW YORK, NJ 07093-3112
(201) 864-3456
(201) 869-7224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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