Broadway Physical Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

BROADWAY PHYSICAL THERAPY, INC.

Practice address

185 Squire Rd
Revere, MA 02151-1234

Phone

(781) 284-0559

Fax

(781) 284-0698

NPI assigned

Dec 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Philip Garofalo, PTA

Title

Owner Director

Phone

(617) 593-3176

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.

• Audrey Ann Xintaropoulos, OTR/L

  • Specialist
  • Malden, MA
  • NPI 1720091275
  NPD (past)
• Lawrence Tatem I, PT

  • Physical Therapist
  • Jamaica, NY
  • NPI 1902206964
  NPD (past)

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

{
    "created_epoch": "1165104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1396813689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SQUIRE RD",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021511234",
            "telephone_number": "781-284-0559",
            "fax_number": "781-284-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 SQUIRE RD",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021511234",
            "telephone_number": "781-284-0559",
            "fax_number": "781-284-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-03",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "GAROFALO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER DIRECTOR",
        "authorized_official_telephone_number": "617-593-3176",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Dondero Brengola, NP
• Scott Brizard, PHARMD, RPH
• Broadway Dental
• Broadway Family Chiropractic, Inc
• Broadway Optical Corp
• Carol Broder
• Johane Brown, RN, FNP
• John Timothy Brown II, PHARMD
• Melissa Brown
• Robert Thomas Bruzzese, L.I.C.S.W.

• Physical Therapist in Revere, MA
• Providers in Revere, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.