Provider Demographics
NPI:1942347224
Name:SOLAN, ELIZABETH O (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:O
Last Name:SOLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:OHARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:546 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1800
Mailing Address - Country:US
Mailing Address - Phone:860-529-6124
Mailing Address - Fax:860-242-5027
Practice Address - Street 1:546 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1800
Practice Address - Country:US
Practice Address - Phone:860-529-6124
Practice Address - Fax:860-242-5027
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42753208000000X
FLME140630208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO83707247Medicaid
FL102999200Medicaid