Provider Demographics
NPI:1821275413
Name:SOLOMON, NIYA RHONDA
Entity Type:Individual
Prefix:
First Name:NIYA
Middle Name:RHONDA
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 ARROW RD STE 107
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1357
Mailing Address - Country:US
Mailing Address - Phone:860-797-8648
Mailing Address - Fax:
Practice Address - Street 1:61 ARROW RD STE 107
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1357
Practice Address - Country:US
Practice Address - Phone:860-797-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0002162251E00000X
LA05800183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No183700000XPharmacy Service ProvidersPharmacy Technician