Healthcare Provider Details

I. General information

NPI: 1457222564
Provider Name (Legal Business Name): PROXIMA SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2025
Last Update Date: 09/13/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SOUTHFIELD AVE APT 506
STAMFORD CT
06902-7665
US

IV. Provider business mailing address

112 SOUTHFIELD AVE APT 506
STAMFORD CT
06902-7665
US

V. Phone/Fax

Practice location:
  • Phone: 718-841-7744
  • Fax: 718-228-9549
Mailing address:
  • Phone: 718-841-7744
  • Fax: 718-228-9549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: GUERRECHON CHATELAIN
Title or Position: MANAGER
Credential:
Phone: 718-841-7744