Provider Demographics
NPI:1598754889
Name:SOLOMON, SOFIA (PT)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 SHIRES WAY
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-4825
Mailing Address - Country:US
Mailing Address - Phone:609-646-9931
Mailing Address - Fax:
Practice Address - Street 1:401 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1200
Practice Address - Country:US
Practice Address - Phone:609-601-2155
Practice Address - Fax:609-601-2156
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA01080300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist