Organization
CENTRAL BROADWAY MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES RAYMOND AVELLINI MD (PRESIDENT)
86633540404
Entity
Organization
Contact information
Practice address
770 BROADWAY FL 2, NEW YORK, NY 10003-9557
(866) 335-4040
(732) 301-8222
Mailing address
364 BROAD ST, KEYPORT, NJ 07735-1619
(866) 335-4040
(732) 301-8222
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
148049
NY
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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