Provider Demographics
NPI:1376824409
Name:BROADWAY HEALTH CARE INC.
Entity Type:Organization
Organization Name:BROADWAY HEALTH CARE INC.
Other - Org Name:BROADWAY HOME CARE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROADWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-633-0022
Mailing Address - Street 1:271 NORTH AVENUE
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5102
Mailing Address - Country:US
Mailing Address - Phone:914-633-0022
Mailing Address - Fax:914-633-8855
Practice Address - Street 1:271 NORTH AVE
Practice Address - Street 2:SUITE 801
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5104
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:2011-09-02
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1417L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1891956124Medicaid
NY1922391044Medicare UPIN