Broadway PT Corp

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

014644 Issued in NY

Legal business name

BROADWAY PT CORP

Practice address

200 S Broadway
2-2
Tarrytown, NY 10591-4500

Phone

(914) 631-1919

NPI assigned

May 10, 2013

Last updated

May 1, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nasrin Javidan

Title

Director

Phone

(914) 631-1919

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1063858520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S BROADWAY",
            "address_2": "2-2",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914500",
            "telephone_number": "914-631-1919",
            "fax_number": "914-631-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BROADWAY",
            "address_2": "2-2",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105914500",
            "telephone_number": "914-631-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY PT CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "JAVIDAN",
        "authorized_official_first_name": "NASRIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "914-631-1919"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Tarrytown, NY
• Providers in Tarrytown, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.