Organization
BROADWAY INTERNAL MEDICINE ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES K MICELI MD (PRES)
(516) 797-1234
Entity
Organization
Contact information
Practice address
585 BROADWAY, MASSAPEQUA, NY 11758
(516) 797-1234
(516) 797-0190
Mailing address
585 BROADWAY, MASSAPEQUA, NY 11758
(516) 797-1234
(516) 797-0190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
09/26/2007
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