Organization
BROADWAY MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH VITOULIS D.O. (OWNER)
(516) 599-9355
Entity
Organization
Contact information
Practice address
120 BROADWAY, LYNBROOK, NY 11563-3233
(516) 599-9355
(516) 593-9355
Mailing address
120 BROADWAY, LYNBROOK, NY 11563-3233
(516) 599-9355
(516) 593-9355
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
X002413
NY
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
205528
NY
207Q00000X
Family Medicine Physician
205528
NY
225700000X
Massage Therapist
Primary
017855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01918905
—
NY
Enumeration date
05/14/2007
Last updated
09/11/2025
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