Provider Demographics
NPI:1659631406
Name:DR. EDEN SOLIMAN
Entity Type:Organization
Organization Name:DR. EDEN SOLIMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDEN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BDS
Authorized Official - Phone:570-587-1560
Mailing Address - Street 1:631 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8913
Mailing Address - Country:US
Mailing Address - Phone:570-587-1560
Mailing Address - Fax:570-586-5922
Practice Address - Street 1:631 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-8913
Practice Address - Country:US
Practice Address - Phone:570-587-1560
Practice Address - Fax:570-586-5922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-020886-L305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization