Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA10763100 | NJ |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 287907-1 | NY |
NPI | 1053756197 |
---|---|
Provider Name | Shirly Solouki |
First Address | New Brunswick, NJ 08901-1962 |
Second Address | New Brunswick, NJ 08901-1962 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2013 |
Last Update Date | 23/07/2021 |