NPIMap

Organization Active NPI

Broadway Respite and Home Care

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Monroe, NJ
National Provider Identifier
1831691120
Registry record updated Mar 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
BROADWAY RESPITE AND HOME CARE
Practice address
20 Lower Matchaponix Ane
Monroe, NJ 08831
Phone
(201) 703-3980
Fax
(201) 703-3984
NPI assigned
Mar 2, 2018
Last updated
Mar 2, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2018

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

Authorized official

Name
Anastasia Vaynberg
Title
Billing Manager
Phone
(201) 703-3980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

20 Lower Matchaponix Ane
Monroe, NJ 08831

Mailing address

17-17 Broadway
Fair Lawn, NJ 07410
Phone (201) 703-3980

Other identifiers 1

IdentifierTypeStateIssuer
0519049MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Broadway Respite and Home Care17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519948800000",
    "number": "1831691120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17-17 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "07410",
            "telephone_number": "201-703-3980",
            "fax_number": "201-703-3984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LOWER MATCHAPONIX ANE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "08831",
            "telephone_number": "201-703-3980",
            "fax_number": "201-703-3984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY RESPITE AND HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-02",
        "last_updated": "2018-03-02",
        "status": "A",
        "authorized_official_last_name": "VAYNBERG",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "201-703-3980"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0519049",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2018; 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.