BROAD STREET WELLNESS CENTER – NPI #1235371576
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

BROAD STREET WELLNESS CENTER is a provider located in CLIFTON, NJ. NPPES has assigned the NPI number 1235371576 to BROAD STREET WELLNESS CENTER on April 01, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was previously updated about 17 years ago on Jun 17, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROAD STREET WELLNESS CENTER below.

NPI Profile for
BROAD STREET WELLNESS CENTER

NPI Number
1235371576
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BROAD STREET WELLNESS CENTER
Primary location
642 BROAD ST
2ND FL; STE 9
CLIFTON, NJ 07013-1615
Phone: (973) 614-9500 Fax:
Mailing address
PO BOX 476
ROSELAND, NJ 07068-0476
Phone: Fax:
Organization Subpart
No
Authorized Official
MARINA BELOZERSKY
OFFICE MANAGER
Phone: (973) 614-9500
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)		 NJ

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.