Provider Demographics
NPI:1114289113
Name:SOLOMON, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MILBURN LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1513
Mailing Address - Country:US
Mailing Address - Phone:718-874-8302
Mailing Address - Fax:718-504-7741
Practice Address - Street 1:105 MILBURN LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1513
Practice Address - Country:US
Practice Address - Phone:718-874-8302
Practice Address - Fax:718-504-7741
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator