Provider Demographics
NPI:1609046010
Name:SOLOMON, LYUBOV
Entity Type:Individual
Prefix:MRS
First Name:LYUBOV
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYUBOV
Other - Middle Name:
Other - Last Name:MUSHEYEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17814 EDGERTON RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1431
Mailing Address - Country:US
Mailing Address - Phone:718-591-0849
Mailing Address - Fax:
Practice Address - Street 1:17814 EDGERTON RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-1431
Practice Address - Country:US
Practice Address - Phone:917-697-7258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist