Provider Demographics
NPI:1174820393
Name:SOLOMON, YAMIT (RN, APN)
Entity Type:Individual
Prefix:
First Name:YAMIT
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-2015
Mailing Address - Country:US
Mailing Address - Phone:201-214-2355
Mailing Address - Fax:
Practice Address - Street 1:569 BROADWAY
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-1663
Practice Address - Country:US
Practice Address - Phone:201-957-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620921163W00000X
NJ26NJ00644400363LP0808X
NJ26NR15100500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse