Central Broadway Medical PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

148049 Issued in NY

Legal business name

CENTRAL BROADWAY MEDICAL PC

Practice address

770 Broadway FL 2
New York, NY 10003-9557

Phone

(866) 335-4040

Fax

(732) 301-8222

NPI assigned

Feb 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. James Raymond Avellini, MD

Title

President

Phone

86633540404

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1699007963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 BROAD ST",
            "city": "KEYPORT",
            "state": "NJ",
            "postal_code": "077351619",
            "telephone_number": "866-335-4040",
            "fax_number": "732-301-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 BROADWAY FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100039557",
            "telephone_number": "866-335-4040",
            "fax_number": "732-301-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL BROADWAY MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "AVELLINI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "86633540404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "148049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in New York, NY
• Providers in New York, NY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.