Provider Demographics
NPI:1477380251
Name:SALOMONI, SOPHIA MARIE (PAC)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE
Last Name:SALOMONI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 EATON AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1832
Mailing Address - Country:US
Mailing Address - Phone:484-526-7474
Mailing Address - Fax:
Practice Address - Street 1:834 EATON AVE FL 1
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1832
Practice Address - Country:US
Practice Address - Phone:484-526-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA007013363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant