Provider Demographics
NPI:1558677385
Name:SOLEYMANI, TARANEH (MD)
Entity Type:Individual
Prefix:
First Name:TARANEH
Middle Name:
Last Name:SOLEYMANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:3100 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-3548
Practice Address - Country:US
Practice Address - Phone:717-948-5180
Practice Address - Fax:717-948-0488
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.30415207R00000X
NJ25MA10137100207R00000X
AL30415208M00000X
PAMD468911207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051111239OtherBCBS
AL051111238OtherBCBS
AL07206253Medicaid
AL124574Medicaid
AL124575Medicaid
AL128635Medicaid
AL051111236OtherBCBS
AL124576Medicaid
AL124577Medicaid
AL051111237OtherBCBS
AL051116862OtherBCBS
AL124576Medicaid