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General NPI Number Information
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NPI Number | 1881765139
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Entity Type | Organization
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Legal Business Name | BROADWAY CARDIOPULMONARY, P.C.
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 110 E 59TH ST SUITE 10B
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City | NEW YORK
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State | NY
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Zip | 10022-1304
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Country | US
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Telephone | 212-407-3950
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Fax | 212-583-2961
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Provider Business Mailing Address
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Address Line | 110 E 59TH ST SUITE 10B
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City | NEW YORK
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State | NY
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Zip | 10022-1304
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Country | US
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Telephone | 212-407-3950
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Fax | 212-583-2961
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Authorized Official
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Title or Position | TREASURER
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Name | FARAH ATALLAH-LAJAM
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Credential | MD
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Telephone | 212-407-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 60-22603
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | 60-22603
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License Number State | NY
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