Marathon Healthcare Center of Waterbury LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2326 Issued in CT

Legal business name

MARATHON HEALTHCARE CENTER OF WATERBURY LLC

Doing business as

Marathon Healthcare Center of Waterbury LLC

Practice address

177 Whitewood Rd
Waterbury, CT 06708-1545

Phone

(203) 757-9491

Fax

(203) 757-4329

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Phyllis A. Belmonte

Title

Receiver

Phone

(860) 644-6780

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Marathon Healthcare Center of Waterbury LLC Doing business as

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1912952359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DR.",
            "address_2": "1ST FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083288",
            "telephone_number": "860-289-8762",
            "fax_number": "860-528-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 WHITEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081545",
            "telephone_number": "203-757-9491",
            "fax_number": "203-757-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARATHON HEALTHCARE CENTER OF WATERBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "BELMONTE",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "RECEIVER",
        "authorized_official_telephone_number": "860-644-6780"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000009001",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00312170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marathon Healthcare Center of Waterbury LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Daria Marcano-Matthews
• Gerard Marcil, LADC
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• Debra Margison
• Eric D Margolies, PSYD

• Skilled Nursing Facility in Waterbury, CT
• Providers in Waterbury, 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 Jun 3, 2009; 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.