Healthcare Provider Details

I. General information

NPI: 1811883010
Provider Name (Legal Business Name): DIABETES INSIGHT AND WEIGHT MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 SPENCER ST STE 2A
MANCHESTER CT
06040-4601
US

IV. Provider business mailing address

112 SPENCER ST STE 2A
MANCHESTER CT
06040-4601
US

V. Phone/Fax

Practice location:
  • Phone: 959-301-9075
  • Fax:
Mailing address:
  • Phone: 959-301-9075
  • Fax: 860-413-0863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHERINE SOLOMON
Title or Position: OWNER
Credential: NP-BC
Phone: 845-242-1975