NPIMap

Organization Active NPI

Broadway Anesthesia Providers, LLC

  • Anesthesiology Physician
  • Paterson, NJ
National Provider Identifier
1093046179
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BROADWAY ANESTHESIA PROVIDERS, LLC
Practice address
680 Broadway
Paterson, NJ 07514-1422
Phone
(908) 994-5204
Fax
(908) 994-5061
NPI assigned
Jan 29, 2010
Last updated
Jan 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Leon Pirak, MDNPI 1134190325
Title
President
Phone
(908) 994-5204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

680 Broadway
Paterson, NJ 07514-1422

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (800) 394-4445

National Provider Directory

National Provider Directory

Locations

680 Broadway
Ste 2
Paterson, NJ 07514
Phone (973) 782-4202

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1093046179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "800-394-4445",
            "fax_number": "706-650-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141422",
            "telephone_number": "908-994-5204",
            "fax_number": "908-994-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY ANESTHESIA PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "PIRAK",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-994-5204",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.