Broadway Comprehensive Vein Center P.C.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

25MA09187400 Issued in NJ

Legal business name

BROADWAY COMPREHENSIVE VEIN CENTER P.C.

Practice address

360 Springfield Ave
Suite 302D
Summit, NJ 07901-4608

Phone

(973) 969-6400

Fax

(609) 949-5555

NPI assigned

Apr 2, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Dallas Broadway, M.D.

Title

President

Phone

(732) 235-0147

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1992048466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GREAT NECK RD",
            "address_2": "APT 3E",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213302",
            "telephone_number": "917-817-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SPRINGFIELD AVE",
            "address_2": "SUITE 302D",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014608",
            "telephone_number": "973-969-6400",
            "fax_number": "609-949-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY COMPREHENSIVE VEIN CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "BROADWAY",
        "authorized_official_first_name": "DALLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-235-0147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "25MA09187400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Pollack, LCSW LLC
• Bridges Outreach, Inc.
• Amy Brightman, LCSW
• Gail Lee Britt, L.C.S.W.
• Howard Stephen Britt, MD
• Shannon E Brophy, NP
• Nancy W Brothers, R.N.
• Erica Bruno, OTR/L
• Sultan Bukhari, DO
• Kellie M Buoye, M.S. CCC-SLP

• Radiology Clinic/Center in Summit, NJ
• Providers in Summit, NJ by specialty
• Radiology Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.