Provider Demographics
NPI:1093950271
Name:SOLIS, EDWIN J (TSHH)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:J
Last Name:SOLIS
Suffix:
Gender:M
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2828
Mailing Address - Country:US
Mailing Address - Phone:732-738-0819
Mailing Address - Fax:
Practice Address - Street 1:92 MACARTHUR DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2828
Practice Address - Country:US
Practice Address - Phone:732-738-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1503892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist