Provider Demographics
NPI:1184203507
Name:SOLOMON, TA SHARAE J (RN)
Entity Type:Individual
Prefix:MS
First Name:TA SHARAE
Middle Name:J
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 FORDHAM HILL OVAL APT 7A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-4827
Mailing Address - Country:US
Mailing Address - Phone:718-484-0120
Mailing Address - Fax:
Practice Address - Street 1:6 FORDHAM HILL OVAL APT 7A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-4827
Practice Address - Country:US
Practice Address - Phone:718-484-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY557366-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse