Healthcare Provider Details

I. General information

NPI: 1285889378
Provider Name (Legal Business Name): PARADIGM CLINICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 05/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 WEST RD SUITE B-1
STRATHAM NH
03885
US

IV. Provider business mailing address

4 WEST RD SUITE B1
STRATHAM NH
03885
US

V. Phone/Fax

Practice location:
  • Phone: 603-772-2076
  • Fax: 603-772-2079
Mailing address:
  • Phone: 603-772-2076
  • Fax: 603-772-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNH

VIII. Authorized Official

Name: MR. THOMAS SCOTT MENKE
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 603-772-2076