Organization
HOME HEALTH PAVILION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MANSOOR ALI HAIDARY (VICE-PRESIDENT)
(860) 210-1313
Entity
Organization
Contact information
Practice address
87 DANBURY RD, UNIT #1, NEW MILFORD, CT 06776-3413
(860) 210-1313
(860) 354-1123
Mailing address
87 DANBURY RD, UNIT #1, NEW MILFORD, CT 06776-3413
(860) 210-1313
(860) 354-1123
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
459952
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12DME0557CT03
BCBS OF CT
CT
01
—
ANC1882
OXFORD
CT
Enumeration date
11/28/2006
Last updated
08/22/2020
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