Provider Demographics
NPI:1578290987
Name:SOLOMON, STEPHANIE GAYLE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:GAYLE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 COMPTON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BELFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07718-1509
Mailing Address - Country:US
Mailing Address - Phone:410-236-3166
Mailing Address - Fax:
Practice Address - Street 1:300 HIGHWAY 35 STE 300
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2216
Practice Address - Country:US
Practice Address - Phone:732-222-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00715200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist