OrganizationActive
Nyc Broadway Health LLC
NPI 1912366147 · Physical Medicine & Rehabilitation Physician · New York, NY
Provider details
- NPI number
- 1912366147
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ivan Baraque, Medical Director(914) 376-6100
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
111 Broadway
Suite 1303
New York, NY 10006-1901
Phone: (914) 376-6100
Fax: (914) 470-5056
Street-level locationGet directions
Mailing address
111 Broadway
New York, NY 10006-1901
Registry dates
- Enumerated
- 2016-02-16
- Last updated
- 2016-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.