Provider Demographics
NPI:1730897331
Name:ZENITH VENTURE LLC
Entity type:Organization
Organization Name:ZENITH VENTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANSOOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:ZENITH2022
Authorized Official - Phone:518-417-0445
Mailing Address - Street 1:101 BALSAM WAY
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-6762
Mailing Address - Country:US
Mailing Address - Phone:518-417-0445
Mailing Address - Fax:518-633-1278
Practice Address - Street 1:101 BALSAM WAY
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-6762
Practice Address - Country:US
Practice Address - Phone:518-417-0445
Practice Address - Fax:518-633-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05684097Medicaid