Healthcare Provider Details

I. General information

NPI: 1275775710
Provider Name (Legal Business Name): BROADWAY MEDICALSTAFFING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 NORTH AVE STE 801
NEW ROCHELLE NY
10801-5107
US

IV. Provider business mailing address

271 NORTH AVE STE 801
NEW ROCHELLE NY
10801-5107
US

V. Phone/Fax

Practice location:
  • Phone: 914-633-0022
  • Fax: 914-633-8855
Mailing address:
  • Phone: 914-633-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number570118-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number570118-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number570118-1
License Number StateNY

VIII. Authorized Official

Name: MR. MICHAEL DONKOR
Title or Position: RN
Credential: RN
Phone: 914-633-0022