Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 68903 | CT |
Y | 208600000X | Surgeon | 68903 | CT |
NPI | 1003261553 |
---|---|
Provider Name | Zachary Tallent Solomon |
First Address | Farmington, CT 06030-3955 |
Second Address | Farmington, CT 06030-3955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 25/10/2021 |