Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00268100 | NJ |
NPI | 1053341438 |
---|---|
Provider Name | Dr. Mark Ephraim Solomon |
First Address | Cedar Knolls, NJ 07927-2109 |
Second Address | Cedar Knolls, NJ 07927-2109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 11/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25MD00268100 | STATE LICENSE (01) | NJ |
BS7727944 | DEA (01) | NJ |
D08132700 | CDS (01) | NJ |