MEDICARE: BROADWAY MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1649466061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROADWAY MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	2 BROADWAY
Second Line	:	SUITE 10
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-2362
Country	:	US
Telephone Number	:	203-234-6500
Fax Number	:	203-234-6503

Provider Business Practice Location Address
First Line	:	2 BROADWAY
Second Line	:	SUITE 10
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-2362
Country	:	US
Telephone Number	:	203-234-6500
Fax Number	:	203-234-6503

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	LORENZO GALANTE
Credential	:	M.D.
Telephone Number	:	203-234-6500

Provider Enumeration Date	:	09/19/2007
Last Update Date	:	04/24/2025

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