Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nyc Broadway Health LLC

Organization Family Medicine Physician · NPI 1912366147

Nyc Broadway Health LLC is a Family Medicine Physician in New York, New York. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111 Broadway Ste 1303
New York, NY 10006-1901
Phone: (914) 376-6100
Fax: (914) 470-5056
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1912366147
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ivan Baraque — Medical Director · (914) 376-6100
NPI enumeratedFebruary 16, 2016
Last updated in NPPESFebruary 16, 2016
Mailing address111 Broadway, Suite 1303, New York, NY 10006-1901

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