Provider Demographics
NPI:1558469023
Name:SOLOMON-IRVING, DEBORAH ANNLYN
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANNLYN
Last Name:SOLOMON-IRVING
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ANNLYN
Other - Last Name:SOLOMON-IRVING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSC, PT
Mailing Address - Street 1:13711 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3842
Mailing Address - Country:US
Mailing Address - Phone:301-262-9472
Mailing Address - Fax:301-262-4436
Practice Address - Street 1:13711 ANNAPOLIS RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3842
Practice Address - Country:US
Practice Address - Phone:301-262-9472
Practice Address - Fax:301-262-4436
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist