Provider Demographics
NPI:1255566543
Name:PARADIGM HEALTHCARE CENTER OF TORRINGTON, LLC
Entity type:Organization
Organization Name:PARADIGM HEALTHCARE CENTER OF TORRINGTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZISKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-729-6268
Mailing Address - Street 1:80 FERN DR
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3807
Mailing Address - Country:US
Mailing Address - Phone:860-482-7668
Mailing Address - Fax:860-496-7815
Practice Address - Street 1:80 FERN DR
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3807
Practice Address - Country:US
Practice Address - Phone:860-482-7668
Practice Address - Fax:860-496-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-15
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTPENDINGMedicaid
CT075105OtherMEDICARE BY ASSIGNMENT