Provider Demographics
NPI:1780677823
Name:SOLAR, MLADEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MLADEN
Middle Name:
Last Name:SOLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3508
Mailing Address - Country:US
Mailing Address - Phone:718-745-4141
Mailing Address - Fax:718-680-0791
Practice Address - Street 1:116 79TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3508
Practice Address - Country:US
Practice Address - Phone:718-745-4141
Practice Address - Fax:718-680-0791
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127918174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist