Provider Demographics
NPI:1255001293
Name:SOLIS, FERNANDO E (PT DPT)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:E
Last Name:SOLIS
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 CLOCK TOWER CMNS
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4057
Mailing Address - Country:US
Mailing Address - Phone:845-278-4127
Mailing Address - Fax:845-278-4128
Practice Address - Street 1:211 CLOCK TOWER CMNS
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4057
Practice Address - Country:US
Practice Address - Phone:845-278-4127
Practice Address - Fax:845-278-4128
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist