Provider Demographics
NPI:1982611729
Name:SOLOMON, BENJAMIN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:ROBERT
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 1:1000 FLORAL VALE BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5569
Mailing Address - Country:US
Mailing Address - Phone:215-785-9500
Mailing Address - Fax:215-785-9470
Practice Address - Street 1:1000 FLORAL VALE BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5569
Practice Address - Country:US
Practice Address - Phone:215-785-9500
Practice Address - Fax:215-785-9470
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068249-L207RP1001X
NJMA07551900207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017881470001Medicaid
PA06-77075000OtherKEYSTONE
PA332738OtherDABS
PA0017881470001Medicaid
PA045424L1HMedicare PIN