Provider Demographics
NPI:1093864563
Name:HALIOUA, SOLOMON (MD)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:HALIOUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MADISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2721
Mailing Address - Country:US
Mailing Address - Phone:201-845-6555
Mailing Address - Fax:201-845-5599
Practice Address - Street 1:22 MADISON AVE STE 201
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2721
Practice Address - Country:US
Practice Address - Phone:201-845-6555
Practice Address - Fax:201-845-5599
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07225300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ057803Medicare ID - Type UnspecifiedMEDICARE
NJH19994Medicare UPIN