Provider Demographics
NPI:1932258324
Name:SOLIMANDO, DOMINIC ANTHONY JR (MA, BCOP)
Entity Type:Individual
Prefix:
First Name:DOMINIC
Middle Name:ANTHONY
Last Name:SOLIMANDO
Suffix:JR
Gender:M
Credentials:MA, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 WILSON BLVD
Mailing Address - Street 2:#110-545
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1859
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4201 WILSON BLVD
Practice Address - Street 2:#110-545
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1859
Practice Address - Country:US
Practice Address - Phone:703-237-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP-029177-L1835X0200X
MD152441835X0200X
VA02020131211835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology