Provider Demographics
NPI:1083613673
Name:SOLL EYE PC OF NJ
Entity Type:Organization
Organization Name:SOLL EYE PC OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOLL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-288-5000
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 510
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-342-7200
Mailing Address - Fax:856-342-6620
Practice Address - Street 1:5001 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-2619
Practice Address - Country:US
Practice Address - Phone:215-288-5000
Practice Address - Fax:215-744-1233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59093174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0038890Medicaid
NJ03908704Medicaid
NJ03908704Medicaid