Provider Demographics
NPI:1760512420
Name:SOLOMON, CRAIG STEVEN (PTA)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:STEVEN
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2153 ELM TREE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-6310
Mailing Address - Country:US
Mailing Address - Phone:301-603-8478
Mailing Address - Fax:301-946-9164
Practice Address - Street 1:10605 CONCORD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2504
Practice Address - Country:US
Practice Address - Phone:301-929-0688
Practice Address - Fax:301-946-9164
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist