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General NPI Number Information
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NPI Number | 1689811192
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Entity Type | Organization
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Legal Business Name | BROAD HEALTH CENTER INC.
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Dates
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Enumeration Date | 01/21/2009
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Last Update Date | 03/23/2009
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Provider Practice Location Address
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Address Line | 2532 N BROAD ST 34
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City | PHILADELPHIA
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State | PA
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Zip | 19132-4013
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Country | US
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Telephone | 888-522-2279
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Fax |
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Provider Business Mailing Address
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Address Line | 2532 N. BROAD ST 34
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City | PHILADELPHIA
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State | PA
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Zip | 19132-4013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARTUR MARUKYAN
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Credential |
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Telephone | 215-847-2167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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