BROADWAY FAMILY PRACTICE PC NPI 1255775821

NPI Information

  • NPI: 1255775821
  • Provider Name: BROADWAY FAMILY PRACTICE, PC
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Organization
  • Address: 22 N FRANKLIN BLVD
    2ND FLOOR
    PLEASANTVILLE, NJ
    ZIP 08232
  • Phone: (609) 272-0655

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NPI Details

BROADWAY FAMILY PRACTICE, PC is a podiatrist in Pleasantville, NJ. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. BROADWAY FAMILY PRACTICE, PC NPI is 1255775821. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

22 N FRANKLIN BLVD
2ND FLOOR
PLEASANTVILLE, NJ
ZIP 08232-547
Phone: (609) 272-0655
Fax: (609) 272-9317

The provider's authorized official is Jon M Regis .
The authorized official title is Owner/president and has the following contact phone number (609) 272-0655.

The enumeration date for this NPI number is 4/25/2013 and was last updated on 4/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristNEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10329282MEDICAIDNEW JERSEY
2064778MEDICARE PINNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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