Provider Demographics
NPI:1265836001
Name:SOLLIDAY, LAUREN ELIZABETH (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:SOLLIDAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 WHITE PLAINS ROAD - ENTA
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5112
Mailing Address - Country:US
Mailing Address - Phone:914-984-2534
Mailing Address - Fax:
Practice Address - Street 1:251 E OAKLAND AVE
Practice Address - Street 2:SUITE 203- ENT AND ALLERGY
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2602
Practice Address - Country:US
Practice Address - Phone:631-828-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002567-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY002567OtherLICENSE NUMBER