Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 57013629 | OH |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 258496 | MA |
NPI | 1558550541 |
---|---|
Provider Name | Ellen R Solomon |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2007 |
Last Update Date | 16/01/2019 |