Provider Demographics
NPI:1518991157
Name:SOLANKI, LAXMI (CDN,RD)
Entity Type:Individual
Prefix:
First Name:LAXMI
Middle Name:
Last Name:SOLANKI
Suffix:
Gender:F
Credentials:CDN,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GREENE RD
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1207
Mailing Address - Country:US
Mailing Address - Phone:845-591-0367
Mailing Address - Fax:845-810-7770
Practice Address - Street 1:4 GREENE RD
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1207
Practice Address - Country:US
Practice Address - Phone:845-591-0367
Practice Address - Fax:845-810-7770
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY587010133N00000X
NJ587010133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9000E1Medicare ID - Type Unspecified
NJ073533Medicare ID - Type Unspecified