Provider Demographics
NPI:1083014468
Name:SOLOTAROFF, CANDICE L (MA)
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:L
Last Name:SOLOTAROFF
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:L
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 SCHRADE RD
Mailing Address - Street 2:2C
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1430
Mailing Address - Country:US
Mailing Address - Phone:845-475-2487
Mailing Address - Fax:
Practice Address - Street 1:317 NORTH ST
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2209
Practice Address - Country:US
Practice Address - Phone:845-475-2487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02415-5235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist