BROAD STREET MEDICAL LLC is a vascular surgery surgery in Philadelphia, PA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. BROAD STREET MEDICAL LLC NPI is 1124670922. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider's business location address is:
2033 S BROAD ST STE B
PHILADELPHIA, PA
ZIP 19148-505
Phone: (215) 809-1447
Fax: (224) 235-4652
The provider's authorized official is Ami Almeda .
The authorized official title is Credentialing Manager and has the following contact phone number (224) 318-0118.
The CLIA number assigned to this NPI record is 39D2198510 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/11/2019 and was last updated on 7/11/2019.