Healthcare Provider Details

I. General information

NPI: 1932575974
Provider Name (Legal Business Name): PARADIGM HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 MULBERRY ST STE 204
LEEDS MA
01053-5321
US

IV. Provider business mailing address

38 MULBERRY ST STE 204 PO BOX 313
LEEDS MA
01053-5321
US

V. Phone/Fax

Practice location:
  • Phone: 413-355-0761
  • Fax: 413-323-7294
Mailing address:
  • Phone: 413-727-3901
  • Fax: 413-727-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSHUA MINTZ
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 413-355-0761