Provider Demographics
NPI:1942307426
Name:MRS. LAXMI SOLANKI CDN PLLC
Entity Type:Organization
Organization Name:MRS. LAXMI SOLANKI CDN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL NUTRITION THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:LAXMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLANKI
Authorized Official - Suffix:
Authorized Official - Credentials:CDN,RD
Authorized Official - Phone:845-591-0367
Mailing Address - Street 1:4 GREENE ROAD
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-1207
Mailing Address - Country:US
Mailing Address - Phone:845-591-0367
Mailing Address - Fax:845-810-7770
Practice Address - Street 1:4 GREENE ROAD
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-1207
Practice Address - Country:US
Practice Address - Phone:845-591-0367
Practice Address - Fax:845-810-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL587010133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9000E1Medicare ID - Type UnspecifiedPROVIDER
NJ07355Medicare ID - Type UnspecifiedPROVIDER