BROADWAY OB GYN LLP NPI 1831315548

NPI Information

  • NPI: 1831315548
  • Provider Name: BROADWAY OB GYN LLP
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • CLIA Number: 41D0713087
  • Address: 695 EDDY ST
    SUITE 21
    PROVIDENCE, RI
    ZIP 02903
  • Phone: (401) 272-1550

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NPI Details

BROADWAY OB GYN LLP is an obstetrics gynecology in Providence, RI. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. BROADWAY OB GYN LLP NPI is 1831315548. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

695 EDDY ST
SUITE 21
PROVIDENCE, RI
ZIP 02903-941
Phone: (401) 272-1550

The provider's authorized official is Bethany R Gardner .
The authorized official title is Practice Administrator and has the following contact phone number (401) 272-1550.

The CLIA number assigned to this NPI record is 41D0713087 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/18/2007 and was last updated on 8/22/2020.

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
1207V00000XObstetrics & Gynecology6660RHODE ISLANDNo
2207V00000XObstetrics & Gynecology11231RHODE ISLANDNo
3207V00000XObstetrics & Gynecology03707RHODE ISLANDNo
4207V00000XObstetrics & Gynecology8281RHODE ISLANDNo
5207V00000XObstetrics & Gynecology5084RHODE ISLANDNo
6207V00000XObstetrics & Gynecology7662RHODE ISLANDNo
7207V00000XObstetrics & Gynecology8926RHODE ISLANDYes

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
19020237MEDICAIDRHODE ISLAND
2FB09430MEDICAIDRHODE ISLAND
39020313MEDICAIDRHODE ISLAND
49002167MEDICAIDRHODE ISLAND
5FP09431MEDICAIDRHODE ISLAND
6LC51020MEDICAIDRHODE ISLAND

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: 11/21/2025

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