Provider Demographics
NPI:1851499701
Name:SOLOMON, REBECCA (MS, RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 FORT WASHINGTON AVE
Mailing Address - Street 2:#5M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3756
Mailing Address - Country:US
Mailing Address - Phone:212-241-2475
Mailing Address - Fax:212-410-0111
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:1190 FIFTH AVENUE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6500
Practice Address - Country:US
Practice Address - Phone:212-241-2475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered