Healthcare Provider Details

I. General information

NPI: 1558621748
Provider Name (Legal Business Name): ALEX SOLTREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 E PUTNAM AVE STE 2B
RIVERSIDE CT
06878-1426
US

IV. Provider business mailing address

1171 E PUTNAM AVE STE 2B
RIVERSIDE CT
06878-1426
US

V. Phone/Fax

Practice location:
  • Phone: 203-629-5800
  • Fax:
Mailing address:
  • Phone: 203-629-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number72180
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number277318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: