Organization · Type 2 NPI
Broad Street Medical LLC
Vascular Surgery Physician · Philadelphia, PA
NPI number
1124670922
Active
Practice location
2033 S Broad St Ste B
Philadelphia, PA 19148-5505
Fax (224) 235-4652
Mailing address
PO Box 302
Northbrook, IL 60065-0302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular Surgery Physician Primary | 2086S0129X | None listed |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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- Pennsylvania Vascular Associates, P.c.Vascular Surgery Physician Philadelphia, PA NPI 1578625349
- Temple University of the Commonwealth System of Higher EducationVascular Surgery Physician Philadelphia, PA NPI 1619965712
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- Nazareth Physician Services IncVascular Surgery Physician Philadelphia, PA NPI 1699726844
About NPI 1124670922
Broad Street Medical LLC's National Provider Identifier is 1124670922, issued on Jul 11, 2019. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Philadelphia, PA. The record was last updated on Jul 11, 2019.