Provider Demographics
NPI:1609040096
Name:I. M. SOLOMON, P.C.
Entity Type:Organization
Organization Name:I. M. SOLOMON, P.C.
Other - Org Name:MONTGOMERY PSYCHOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-278-0877
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-0607
Mailing Address - Country:US
Mailing Address - Phone:610-278-0877
Mailing Address - Fax:610-278-6028
Practice Address - Street 1:5306 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HAVERFORD
Practice Address - State:PA
Practice Address - Zip Code:19041-2018
Practice Address - Country:US
Practice Address - Phone:610-278-0877
Practice Address - Fax:610-278-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA 003490L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty