Provider Demographics
NPI:1205801321
Name:SOLIS, J. LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:J. LOUIS
Middle Name:
Last Name:SOLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LOUIS
Other - Middle Name:J
Other - Last Name:SOLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:185 RYKOWSKI LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4055
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:241 NORTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1154
Practice Address - Country:US
Practice Address - Phone:845-483-5253
Practice Address - Fax:845-485-3804
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2163392085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02384632Medicaid
NYP00219617Medicare PIN
NY02384632Medicaid
NY639S11Medicare PIN