Healthcare Provider Details

I. General information

NPI: 1821275413
Provider Name (Legal Business Name): NIYA RHONDA SOLOMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2008
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 ARROW RD STE 107
WETHERSFIELD CT
06109-1357
US

IV. Provider business mailing address

61 ARROW RD STE 107
WETHERSFIELD CT
06109-1357
US

V. Phone/Fax

Practice location:
  • Phone: 860-797-8648
  • Fax:
Mailing address:
  • Phone: 860-797-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCA0002162
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number05800
License Number StateLA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: