Organization
PARADIGM HEALTHCARE CENTER OF PROSPECT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT L ZISKIN (MEMBER/VICE PRESIDENT)
(860) 729-6268
Entity
Organization
Contact information
Practice address
25 ROYAL CREST DR, PROSPECT, CT 06712-1486
(203) 758-4431
(203) 758-5601
Mailing address
25 ROYAL CREST DR, PROSPECT, CT 06712-1486
(203) 758-4431
(203) 758-5601
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075207
MEDICARE BY ASSIGNMENT
CT
05
—
PENDING
—
CT
Enumeration date
05/15/2009
Last updated
05/15/2009
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