Provider Demographics
NPI:1396820619
Name:MOSHE, SOLOMON L (MD)
Entity Type:Individual
Prefix:
First Name:SOLOMON
Middle Name:L
Last Name:MOSHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:55 MARCOURT DR
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-2506
Mailing Address - Country:US
Mailing Address - Phone:718-405-8140
Mailing Address - Fax:718-405-8149
Practice Address - Street 1:MMC - DEPT. OF NEUROLOGY
Practice Address - Street 2:1515 BLONDELL AVENUE, STE. 220
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1248682084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology