Broadway Chiropractic & Rehabilitation Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00677300 Issued in NJ

Legal business name

BROADWAY CHIROPRACTIC & REHABILITATION CENTER

Practice address

473 Broadway
Bayonne, NJ 07002-3697

Phone

(201) 471-2273

Fax

(201) 471-2274

NPI assigned

Jan 22, 2010

Organization subpart

No

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

Authorized official

Name

Alexander Mazurovsky

Title

President

Phone

(917) 648-1005

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• John Bortolussi, D.C.

  • Chiropractor
  • Clifton, NJ
  • NPI 1730289729
  NPD (past)
• Jonathan Orio Gonzaga, PT

  • Specialist
  • Fair Lawn, NJ
  • NPI 1629248562
  NPD (past)

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264118400000",
    "number": "1326379850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023697",
            "telephone_number": "201-471-2273",
            "fax_number": "201-471-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023697",
            "telephone_number": "201-471-2273",
            "fax_number": "201-471-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY CHIROPRACTIC & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A",
        "authorized_official_last_name": "MAZUROVSKY",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-648-1005"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00677300",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "38MC00677300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian C. Della Pesca Ma LPC, LLC
• Telema Briggs, PH.D.
• Broad Specialty Pharmacy
• Broad Specialty Pharmacy
• Broadway Care Pharmacy LLC
• Broadway Oral Surgery, LLC
• Broadway Physical Therapy, LLC
• Broadway RX Inc
• Herman Brockman
• Ira Mark Brooks, MD

• Chiropractor in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.