MEDICARE: BROADWAY DIAGNOSTIC MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1528851581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROADWAY DIAGNOSTIC MEDICINE PC

Provider Business Mailing Address
First Line	:	923 BROADWAY
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1739
Country	:	US
Telephone Number	:	917-304-3316
Fax Number	:

Provider Business Practice Location Address
First Line	:	923 BROADWAY
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1739
Country	:	US
Telephone Number	:	917-304-3316
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. DAVID STEINER
Credential	:
Telephone Number	:	917-304-3316

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

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