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General NPI Number Information
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NPI Number | 1568107811
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Entity Type | Organization
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Legal Business Name | BROAD HEALTH, P.A.
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Dates
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Enumeration Date | 05/02/2022
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 16192 COASTAL HWY
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City | LEWES
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State | DE
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Zip | 19958-3608
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Country | US
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Telephone | 402-650-3424
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Fax |
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Provider Business Mailing Address
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Address Line | 154 W 16TH ST # 6-110
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City | NEW YORK
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State | NY
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Zip | 10011-6201
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Country | US
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Telephone | 617-513-4838
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES STAHELI
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Credential | DO
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Telephone | 402-650-3424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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