Organization
BROADWAY PEDIATRICS M.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE PEREZ M.D. (PRESIDENT)
(212) 740-3900
Entity
Organization
Contact information
Practice address
4250 BROADWAY, SUITE 1C, NEW YORK, NY 10033-3748
(212) 740-3900
(212) 740-8232
Mailing address
4250 BROADWAY, SUITE 1C, NEW YORK, NY 10033-3748
(212) 740-3900
(212) 740-8232
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01620699
—
NY
Enumeration date
05/21/2007
Last updated
07/07/2011
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