Provider Demographics
NPI:1336151158
Name:SOLOMON, MARK DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DAVID
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:38 CASEY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2353
Mailing Address - Country:US
Mailing Address - Phone:631-928-0990
Mailing Address - Fax:631-928-7547
Practice Address - Street 1:701 ROUTE 25A
Practice Address - Street 2:SUITE B1
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2050
Practice Address - Country:US
Practice Address - Phone:631-331-4403
Practice Address - Fax:631-331-1932
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2008-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY188451207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01552189Medicaid
NY49H972OtherEMPIRE BCBS
NYPRV0004550OtherMONTEFIORE
NY4611929OtherAETNA
NY0C4369OtherPHS
NY0570430012OtherCIGNA
NY110090140OtherRAILROAD MEDICARE
NY43342OtherVYTRA
NYP846294OtherOXFORD
NY110090140OtherRAILROAD MEDICARE
NY01552189Medicaid