Provider Demographics
NPI:1598271983
Name:SOLYAK, MEGAN CB (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CB
Last Name:SOLYAK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:C
Other - Last Name:BURGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:51 PETERS ROAD
Mailing Address - Street 2:STE 200
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7685
Mailing Address - Country:US
Mailing Address - Phone:717-626-2167
Mailing Address - Fax:717-626-1915
Practice Address - Street 1:51 PETERS ROAD
Practice Address - Street 2:STE 200
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7685
Practice Address - Country:US
Practice Address - Phone:717-626-2167
Practice Address - Fax:717-626-1915
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA059690363A00000X, 363AM0700X
PART004423207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine