Provider Demographics
NPI:1700814233
Name:SOLOMON, JOEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:SOLOMON
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 1:161 MADISON AVE RM 5SE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5456
Mailing Address - Country:US
Mailing Address - Phone:212-448-0101
Mailing Address - Fax:212-448-0116
Practice Address - Street 1:161 MADISON AVE RM 5SE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5456
Practice Address - Country:US
Practice Address - Phone:212-448-0101
Practice Address - Fax:212-448-0116
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-03-02
Deactivation Date:2023-02-06
Deactivation Code:
Reactivation Date:2023-02-23
Provider Licenses
StateLicense IDTaxonomies
NY150906207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61395Medicare UPIN