Provider Demographics
NPI:1255535217
Name:SOLOWAY, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:SOLOWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2014 S FEDERAL HWY
Mailing Address - Street 2:#B107
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6964
Mailing Address - Country:US
Mailing Address - Phone:201-224-6733
Mailing Address - Fax:
Practice Address - Street 1:200 WINSTON DR
Practice Address - Street 2:# 1607
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010
Practice Address - Country:US
Practice Address - Phone:917-656-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50110207L00000X, 208D00000X
CAA43410207L00000X, 208D00000X
IA24420207L00000X, 208D00000X
NJ25MA04839700208D00000X, 207L00000X
NY166054-1208D00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
A29694Medicare UPIN