Broad Street Wellness Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BROAD STREET WELLNESS CENTER

Practice address

642 Broad St
2ND FL; Ste 9
Clifton, NJ 07013-1615

Phone

(973) 614-9500

NPI assigned

Apr 1, 2009

Organization subpart

No

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

Authorized official

Name

Marina Belozersky, CPA

Title

Office Manager

Phone

(973) 614-9500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grace Melendez, MD

  • General Practice Physician
  • Clifton, NJ
  • NPI 1710971676
  NPD (past)
• Arthur Turovets, D.C.

  • Chiropractor
  • Clifton, NJ
  • NPI 1043267750
  NPD (past)

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1235371576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 476",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070680476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 BROAD ST",
            "address_2": "2ND FL; STE 9",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131615",
            "telephone_number": "973-614-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD STREET WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "BELOZERSKY",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-614-9500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Pamela Bravo, LSW, CADC
• Brendan P Sullivan MD Facc LLC
• Lorraine Brenner, D.M.D
• Tanya Bressel
• Broad Street Surgical Center, LLC
• Andrew Broadfoot
• Eva Broadfoot
• Broadway Applied Behavior Analysis PLLC
• Broadway Medical Group PC
• Tara Sofia Brock, MA, LPC

• General Practice Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.