Provider Demographics
NPI:1275775710
Name:BROADWAY MEDICALSTAFFING INC
Entity Type:Organization
Organization Name:BROADWAY MEDICALSTAFFING INC
Other - Org Name:BROADWAY HEALTH CARE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DONKOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:914-633-0022
Mailing Address - Street 1:271 NORTH AVE STE 801
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5107
Mailing Address - Country:US
Mailing Address - Phone:914-633-0022
Mailing Address - Fax:
Practice Address - Street 1:271 NORTH AVE STE 801
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5107
Practice Address - Country:US
Practice Address - Phone:914-633-0022
Practice Address - Fax:914-633-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY570118-1251E00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY570118-1OtherRN