Provider Demographics
NPI:1619136637
Name:SOLOMON, ALIZA B (DO)
Entity Type:Individual
Prefix:DR
First Name:ALIZA
Middle Name:B
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10230 67TH AVE
Mailing Address - Street 2:7R
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2455
Mailing Address - Country:US
Mailing Address - Phone:718-830-0951
Mailing Address - Fax:
Practice Address - Street 1:10230 67TH AVE
Practice Address - Street 2:7R
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2455
Practice Address - Country:US
Practice Address - Phone:718-830-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2363372080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology