Provider Demographics
NPI:1427388495
Name:SOLOMON, NAVA
Entity Type:Individual
Prefix:
First Name:NAVA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 TALBOT ST
Mailing Address - Street 2:APT 7-F
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3555
Mailing Address - Country:US
Mailing Address - Phone:973-919-5989
Mailing Address - Fax:
Practice Address - Street 1:8300 TALBOT ST
Practice Address - Street 2:APT 7-F
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3555
Practice Address - Country:US
Practice Address - Phone:973-919-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018312103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical