Provider Demographics
NPI:1821002304
Name:SOLBY, RICHARD ADAM (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ADAM
Last Name:SOLBY
Suffix:
Gender:M
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:PO BOX 1250
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-0010
Mailing Address - Country:US
Mailing Address - Phone:518-773-5758
Mailing Address - Fax:518-773-5456
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:MAB 101
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-0000
Practice Address - Country:US
Practice Address - Phone:518-773-5246
Practice Address - Fax:518-773-5252
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200921208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02089178Medicaid
NY10021176OtherCDPHP
NY26534OtherMVP HEALTH PLAN
NY02089178Medicaid
NY54176OtherEMPIRE BLUE CROSS