Provider Demographics
NPI:1700916533
Name:RAYMOND L. SOLETIC
Entity Type:Organization
Organization Name:RAYMOND L. SOLETIC
Other - Org Name:MANHASSET OTOLARYNGOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:SOLETIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-365-7952
Mailing Address - Street 1:1615 NORTHERN BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3033
Mailing Address - Country:US
Mailing Address - Phone:516-365-7952
Mailing Address - Fax:516-365-7233
Practice Address - Street 1:1615 NORTHERN BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3033
Practice Address - Country:US
Practice Address - Phone:516-365-7952
Practice Address - Fax:516-365-7233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWF8231Medicare ID - Type Unspecified