Spectrum Healthcare Waterbridge, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2261 Issued in CT

Legal business name

SPECTRUM HEALTHCARE WATERBRIDGE, LLC

Doing business as

Hilltop Health Center

Practice address

126 Ford St
Ansonia, CT 06401-2635

Phone

(860) 871-5454

Fax

(860) 871-5757

NPI assigned

Nov 7, 2005

Last updated

Aug 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Howard William Dickstein, PHD

Title

Chief Executive Officer

Phone

(860) 871-5454

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hilltop Health Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1104807304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 FORD ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012635",
            "telephone_number": "860-871-5454",
            "fax_number": "860-871-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 FORD ST",
            "city": "ANSONIA",
            "state": "CT",
            "postal_code": "064012635",
            "telephone_number": "860-871-5454",
            "fax_number": "860-871-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTHCARE WATERBRIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "DICKSTEIN",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "860-871-5454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000021204",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hilltop Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie C Solazzo, PH.D.
• Liqun Song, M.D.
• Milton A Soriano, MSW
• Michelle Marie Sousa-Paco, MA
• Southern Connecticut Dental Group PC
• Roman Spivak, MD
• Matthew Paul Staniewicz, LMSW
• Mary Ellie Stankus, APRN, RN
• Ira J Stein, DDS
• Stephen Moses, M.D., LLC

• Skilled Nursing Facility in Ansonia, CT
• Providers in Ansonia, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.