Provider Demographics
NPI:1699930743
Name:NORTH BROADWAY INTERNAL MEDICINE PC
Entity type:Organization
Organization Name:NORTH BROADWAY INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-966-1430
Mailing Address - Street 1:970 N BROADWAY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1309
Mailing Address - Country:US
Mailing Address - Phone:914-966-1430
Mailing Address - Fax:914-595-4982
Practice Address - Street 1:970 N BROADWAY
Practice Address - Street 2:SUITE 310
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1309
Practice Address - Country:US
Practice Address - Phone:914-966-1430
Practice Address - Fax:914-595-4982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty