Provider Demographics
NPI:1225162084
Name:SOLOMON, RUTH FAY (SW)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:FAY
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 CIRCLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROSYLN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2697
Mailing Address - Country:US
Mailing Address - Phone:516-621-7880
Mailing Address - Fax:
Practice Address - Street 1:33 CIRCLE DRIVE
Practice Address - Street 2:
Practice Address - City:ROSYLN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2697
Practice Address - Country:US
Practice Address - Phone:516-621-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03746011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
04936Medicare ID - Type Unspecified