Provider Demographics
NPI:1467472761
Name:SOLOMON, HOWARD DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:DAVID
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10460 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7301
Mailing Address - Country:US
Mailing Address - Phone:718-275-5555
Mailing Address - Fax:718-275-2610
Practice Address - Street 1:10460 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7301
Practice Address - Country:US
Practice Address - Phone:718-275-5555
Practice Address - Fax:718-275-2610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118062207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY004473476Medicaid
NY004473476Medicaid
NYC07546Medicare UPIN