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General NPI Number Information
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NPI Number | 1346408796
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Entity Type | Organization
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Legal Business Name | PARADIGM MEDICAL CARE, LLC
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Dates
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Enumeration Date | 06/01/2008
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 400 MILL PLAIN RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-5048
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Country | US
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Telephone | 203-763-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 575 WINNEPOGE DR
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City | FAIRFIELD
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State | CT
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Zip | 06825-2562
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Country | US
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Telephone | 203-763-9452
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. ELIZABETH TAN KAMLANI
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Credential | APRN
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Telephone | 203-763-9452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 01334712
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 003040
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License Number State | CT
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