Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1245896695 |
---|---|
Provider Name | Paul Soloway |
First Address | Ithaca, NY 14850-2275 |
Second Address | Ithaca, NY 14850-2275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2019 |
Last Update Date | 11/05/2019 |