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General NPI Number Information
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NPI Number | 1174484661
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Entity Type | Organization
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Legal Business Name | UPTOWN BROADWAY MEDICAL PC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 65 BROADWAY STE 1004
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City | NEW YORK
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State | NY
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Zip | 10006-2550
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Country | US
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Telephone | 646-559-0585
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Fax | 646-559-2061
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Provider Business Mailing Address
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Address Line | 65 BROADWAY STE 1004
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City | NEW YORK
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State | NY
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Zip | 10006-2550
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Country | US
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Telephone | 646-559-0585
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Fax | 646-559-2061
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEANJACQUES MBABUIKE
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Credential | MD
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Telephone | 914-806-5332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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