Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 028166-1 | NY |
NPI | 1134104110 |
---|---|
Provider Name | Dr. Marshall P. Solomon |
First Address | Brooklyn, NY 11203-2056 |
Second Address | Brooklyn, NY 11203-2056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U43995 | (02) | NY |